HomeMy WebLinkAbout07010008 Application
City of Carmel! Clay Township Permit #: 0 TDI 0 00 ~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
PHONE:
(Z-VL-tP tlv,t.J7/fl-f f,5.1/ vl1i:iZ5~. 3(7..-9{~,'1iYt~
STREET ADDRESS:
ft7~:3 cfl.4(Ci 91. #;({)O
FAX:
3/"7 -c;-qS--Zfbf
NAME:
CITY:
!r....I>I4>^JAI'ot.-IS
STATE:
"J:,J
ZIP:
4bz.S'V
BUILDER'S EMAIl ADDRESS:
SM"""k..... e.. ~~ hv.'{J~t'S _ <'oM..
BEST METHOD OF CONTACT:
~ I<'l.<<~ 3/7- "714. - <;;''''7 & '2-
PROPERTY
OWNER:
NAME: MofJo,J ~ MAt..>, ~
PHONE:
~17-~-q~s
FAX:
3{'7-<)li..-Z/4- I
LOCATION
&. PROJECT
INFO:
STREET ADDRESS:
&'-S~3
LOT #:
3B
cftAdt;
!it. tf; (c:c>
CITY:
:r.....I>IA.rvJ, P",\.-lC
STATE:
r~
ZIP:
<ft. z.,-z:>
ZONING: P IJ tl>
SQUARE "
FOOTAGE: -' , 7':<1
~~ / ~f!J 00
~~
NAME OF UTILIlY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE). 1>0 '1#< t) 1 "03 /)40 7CC oS
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL #: Ib-OC/ - ZS-oz.-Q$--v2D-
FOR THIS PROPER1Y: Ib -O<{ _ 2> _0' -o~ - /J Z
TYPE OF CONSTRUCTION: OF IMPROV MENT: PLUMBING CONTRACTOR:
~SINGLE FAMILY . NEW STRUCTURE ~~ rz.~ (2. f'L,.JM 13v.l~
TOWN HOME . ~. "'Uf"" Plumber's Indiana State License #:
TWO FAMILY RELEASED F ,. fY'.L) ,-
# of units '-.Q~~ct to compIlWl,,::~IlCi~AIlDmN;j s vr~ I) l? 00 I '3;:.
~on5~cte 5 of State and L..~P@~es.. I Which plumbing codes will be applied to the construction:
o RES~D~NTIAL [!jfiPT OF COMfy1l1Wfst~~~n V @ntemational Residential Code w/Indiana Amendments
Additions, R~s.likAARM""' N"i4ll:"'EP~Rlp _ .
lill T ur \J ~~HED GARAGE 0 UnIform Plumbing Code w/Indiana Amendments
PROJECT INFORMATION: 1 LITIDN FOUNDATION TYPE: (Check all that apply for the new
Early Release ~ ')( Manufactured [";) . construction area)
Permit: ~Y ,L.;.N Trusses: I.Jt-Y _N 0 CRAWLSPACE 0 POST & _ BEAM ~PIER
Lot Split: _Y ~ Sump Pump: _Y -@ @SLAB 0 BASEMENT (WALKOLIT:_Y_N )
ADDRESS OF CQNSTRUcnON:
3~Z. j.<J. MAIl'> 4).
CA~€l-t T~
SEeTIO
rJA
th.212.-
SUBDIVISION NAME:
fr!O"DN". MltuJ
SEWER UTIUlY
PROVIDER:
t/ft fl.M..~L.
WATER UTILIlY
PROVIDER:
Cf',(Z.Mf3i-
ESTIMATED COST OF CONSTRUmON:
(EXCLUDING lAND VALUE)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences within 180
days of the date of issuance of the building permit, and must he completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana - 1993" (Z'
289) and amendments, adopted under authority of r.c. 36,7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floot drains ace connected t~:ary sewee. I further certify that the comtruction will not be ",ed or occupied until a Certificate of
Occupancy . eni, ledb the~eParr f ommUnitYServices.cann~;. M. Kq;;:U 112./01
Signature of 0 r or A oozed Agent Print Date ,
Site
~~.50
# Charged Re-
Reviews
ReViewed/Approved: Dept. of Community Services (Dale)
S:Permits/formsjILP RESIDENTIAL
Date