HomeMy WebLinkAbout07010011 Application
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City of Carmel/Clay Township Permit #: 0 7() (00 II
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
ZIP:
4t>z~
ZONING:
'Pu~
~g~~E: iitId~1
.~-. ~t~ Do
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET IJ/I-U? BXU\Vfl<~"J"1, u
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLlCAB ): &P ~ /:PM J;. D'\-t>1 D03 O<l-O"lD.:> '52
:JJO ()/o067 TAX MAP PARCEL #: jb-oq -2-5"-02- - .3-0ZD.
T' /h-OCf.-")..--o'Z-O;/-O;tl.
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMEIY: ~ PLUMBING CONTRACTOR:
.Q.".SINGLEFAMILY (i) NEW STRUCTURE ~~ ~1f- P/N~rt:(
<!!P'TOWN HOME 0 ROOM ADDITION(S) Plumber's Indiana State License #:
o TWO FAMILY 0 PORCH ADDmON(S) 0 I? C
#ofun~ 0 DECKADDmON(S) CI~W()/) ::>.21
c.onstru ED FOR <co;e"IrTlnM ~'Ch plumbing codes will be applied to the construction:
t,me:---8ubiect.to complianC&wi ~R\il'~_lff:Fhfish only
o RESIDENTIAL tFor. 0 S~ING nternational Residential Code wfIndiana Amendments
AdditionS,.BlmIllllel?!. itP-/f and ~ D GARAGE
Ul::t"T OF COMMl.InJI1\'YI"~~E Uniform Plumbing Code wfIndiana Amendments
PROJECT Iffllbl(~NlMEL /i(:~"t)WfI]SHIP FOUNDATION TYPE: (Check all that apply for the;,new
~ IND.l.A' , ,@> construction area)
Early Release v' ....niJf;lctured
Permit: "' Y N TrusSes: Y N 0 CRAWLSPACE 0 POST & BEAM _PIER
Lot Split: _Y ~ Sump Pump: Y ~ LAB 0 BASEMENT (WALKOUT:_Y_N )
BUILDER
OF
RECORD:
NAME:
f).. 'j, "'"'"""""./ P~~~~ '.
r.;v IVV"'> r-::> "f'"'C./ 3. 1- 5"f.> -I( S
CITY:
'T.u,t./A...A:f'Dl.1 C;
STATE:
'I:t-l
STREET ADDRESS:
(?~y3
. -8'/)v
Il~bv"ld.ev) .t:f""'-.
elM It(
BEST METHOD OF CONTACf:
frI~tf,;7L
BUILDER'S EMAIl ADDRESS:
~MrA-i..-g
PROPERTY
OWNER:
NAME:
MO,VON ~ /VIAI,J U.t.-
PHONE:
3/'1-<;;<[5"-1#1 r-
LOCATION
& PROJECT
INFO:
STREET ADDRESS:
g~9
LOT #:
3G
CITY:
r.oll IAI\JAJ:bv<"7
STATE:
cJl.4let -;,r. ttlOO
T"J
SUBDIVISION NAME:
1V/I/oJ{).J of /VIA.,J
SECTION:
t.IA
4b2-3"2...-
ADDRESS OF CONSTRUCTION:
1-z.'ir Lv f>1t}\fI) <)ir.
CAIl-rt6\.- ']:,.J
SEWER UTILITY
PROVIDER:
WATER UTILITY
PROVIDER:
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
~61-
c.Atl-M~
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
1D~G
x
FAX:
311- S-~-;;Uh-'
ZIP:
'Z.~
,i1'71tf--5'"71i72-
FAX:
3i'1-9lS'- ZI4-1
,~.....
~
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 be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure pennits 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 I.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 floor drains are connected the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupanc as, e 58U db the e nt of Community Services, Carmel, Indiana.
~f^' Mos~
Signature
Print
lz,frv;-Iob
Date
OFFICEUSEONLY:******************************************************~*************************
SPECTIONS REQUIRED: Filing Fees: f? 07- /0
Base Inspections: ,;2 ?? ,)0
5.J.Sc:?
~ .-- I/W-? ~''p{. Additional Fees
~ ~P/o
4 .
Fee Received by: "
Cert. of Occupancy:
(Date)
# Charged Re-
Reviews
Date