HomeMy WebLinkAbout06120100 Application
City of Carmel/Clay Township Permit #:~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER NAME: .-r PHONE: FAX:
OF )<(~ A 9",[( 6..f.~ <,,.,,.~-,. <p-~ ]/7 7~7- <t);l-{. :>0 77<1 In";
RECORD: STREET ADDRESS: CTIY: STATE: ZIP:
P.o, 13<.< 7-'{ e; '::'$&<< .;::-" '(6CJ'?
BUILDER'S EMAIL ADDRESS: 4..1. BEST METHOD OF CONTACT:
Jpl..... 4 d,," @I cC'~ fJ".\~
PROPERTY NAME:. - () 1/. Is:" PHONE: FAX:
OWNER: LI~dL ~'I'I 7>35
STREET ADDRESS: CITY: STATE: ZIP: 4'6033
413) A lof e.- s,.:} 0-1" Cc{rj~cll ...;::" <jb--JlJ '/~
LOCATION ,,~~T #: I W1 SUBDIVISION NAME: SEmON: ZONING: R.;L
&. PROJECT T /3.<<0 '" f l, ,",.. 1011'5" .~.,
IftlllI""
.
INFO: ADDRESS OF CONSTRUfTION: SQUARE fr-H
if 733 Ald~ra.q.f, FOOTAGE:
SEWER UTILITY WATER UTILITY Cttrme-/ T ESTIMATED COST OF CONSTRUCT10N:
PROVIDER: C arl'Ylel ~J,.!'ROVIDER: (EXCLUDING LAND VALUE) ? / 'I (J < Co
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
FLOOD ZONE AREA DE~~ON(S) )( ll,lt1sWe.d) I TAX MAP PARCEL #~. _~_~-'-':---;;r--'--:'~-7! ; ;~;: \;: <\ \, ,
FOR THIS PROPERTY: ,
-'--- . __.~ 1{'_.. ,\ \-./: \L.~,<.\
~ '..- ~ ,--- u " ___'1 '
Manufactured ~
Trusses: Y N
Sump pu~~C"\\O~~ N
:\~"'. \0
For Single Family and Two F~_l i~~. s~~ru.\hI. ~-OdelS' or accessory structures, this pennit is valid only if construction commences within 180
days of the date of is :OUh~ o~~e.nw~ eted (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure pe . ect ~'Wt':i.~~ ~&tUS es.. ~V\\~ate of Indiana (See 675 lAC l2) regarding expiration time frames for beginning and
.\beC\\O ~e.\e.?J,0 '_~ \~\\{.....'-N~pletingcons=ction.
I, the undersigne$'Ilgt~e thadn9'c~il.t\-fe>Q\ls~b(:t1,~enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by thIS applicati~ ~o ~' a~~o'rm to, all applicable laws of the State of Indiana, and the ~Zoning Ordinance of Carmel Indiana - 1993" (Z'
, 289) and amendmenf8\~\ed-GQ,Q~~ . Pi ~~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitch n, bath, and fkJrtfr ,i~e ~hnecte~ It\J?anitary se~er. I ~rther certify tha~ the construction will not be used or occupied until a Certificate of
Occu . has be u d~y the Department of Commurnty Serv'lces, Cannel, Indiana.
. ,J.J.... A. De-II
OFFICE USE ONLY: ***************** ********** ***~~******~ *************7**3**~cf******** *********
INSPECTIONS REQUIRED: FIling Fees. ,? . JL
. _ Base Inspections: I L,I {)() # Charged Re-
Upper FootIng Lower Footing Under Slab ( '- '. "'--0 Reviews
o. .. ~.:: Cert. of Occupancy: ..5 3. J
~Ugh9 Meter Base .i.!'.al Site ~
______ P,R.LF.: Additional Fees
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
-y --!;
-y ---G>
Lot Split:
Sigra re of Owner or Authorized Agent
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL
;/ Basement Finish only
o ACCESSORY IIUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
PLUMBING CONTRACTO~:~\ \~L':~!.:.:-.?_----_. \ \ I~\ \\
; ~ \ j) \ \ \
Plumber's Indiana State Li,ih t: Ute 1 ~ i.ca~\\u j
ill '-'\ ___-
Which plumbing codes will be applied toth'eeonstruction:
o International Residentia\1 Code w/Indiana-Amef1"d~
l--'
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPA9' 0 POST & BEAM PIER
o SLAB rsI BASEMENT (WALKOUT: W ~-1hd
't.-
fe\\
12'J-y'DC
Print
Date
Date
00
I
Dept. of Community Services
S;Permits!forms!IlP RESIDENTIAL
/ - ;iJ-iJ
F