HomeMy WebLinkAbout07010012 Application
City of Carmel/Clay Township Permit #: D70 I 00 I'd-.
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
NAME:
~LG ql)~~ ~;j,~
PHONE:
r;f.lb. JI1-.,<ts--1oq<
FAX:
3,,- 5'l~- 2/'" I
STREET ADDRESS:
~:j<i?, Cfi-4te, 9,-- 1tlOO
CITY:
'J:tvbtA/.J/<Pl>IAS
STATE:
r~
ZIP:
'f&Z<;7/
BUILDER'S EMAIl ADDRESS:
~-A1M~.A2v ~ l\S~ bvi(M~ - ."'"
BEST METHOD OF CONTACT:
3/1-114--n l?2-
FAX: i
~i7-';<lS--~ib
PROPERTY
OWNER:
NAME:
Nlo (),J 't ,vi 4 LJV . /.-(.,e....
PHONE:
gI1-S7l~-'ltGl~
LOCATION
& PROJECT
INFO:
STREET ADDRESS:
g-?~,
LOT #: "-
1.!J
t-e4(~ ST. tJ;lDO
CITY:
rj.) l) iA....>4Po/..-l 5
STATE:
r,.,
ZIP:
4V2.~
ZONING:
pvD
.~ ~
SUBDIVISION NAME:
111 O~Of.) 1 ~4(.J
SECllON:
1.1 ft.
ADDRESS OF CONSTRUCTION:
3'1. ,.; MAt.,) 4(-.
,,~ .'?-o., ODO
,
r,,1) ~,.le
IX ~Ooro
#70I()O!;'& TAXMAPPARCEL#:lb-<>'!':ZS-...oz-"'3.-o:u>.o
705 Ib-Ii"l-2S--0:2--';>~-f);z..(.o v
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
o SINGLE FAMILY /ii)NEWSTRUCTURE O~ 12-~ ~ fw.I.'R,u'>4
,.!IOTOWN HOME '-d' ROOM ADDITION(S) Plumber's Indiana State License #:
'-B TWO FAMILY 0 PORCH ADDmO.III~) .
# of units _A~t:;D'F'~ '(f}E<l~~~~N C,f'EX5f?' DO' ~
c.onstructe . '''':!'' ~:R~t:lfiIP.u reaulations
tlme:~ect to cOmpilanOO:W'Il\i.~~el1t Finish only @ plumbing codes will be applied to the construction:
o RESIDENTIAL {FOr' of State ami ~OR.ljIibUIL~g ntematlonal ReSidential Code w/Indlana Amendments
Additions. Rem[f~~f~l= CO~'\:~ff.~~SHIP 0 Unifonn Plumbing Code w/Indiana Amendments
PROJECT INF06ltYrQf: CARMEl.. I?>E~omI FOUNDATION TYPE: (Check all that apply for the new
INDIANA construction area)
Early Release r:;--., Manufactured ~
Permit: WY _N Trusses: &Y _N 0 CRAWLSPACE
_Y.@ Sump Pump: _Y ~
t/Pt/UtII Gl.-
NAME OF LmLITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET /'" "'ilA-S
NUMBERS; TAC DATE(S); AND/OR COUNlY WELL AND/OR SEPTIC PERMIT #'S (IF APPUUl\lLE):
CAIU1a.
c-A/l.-Wf.eL. I,.J
4b Z~z..
SQUARE
FOOTAGE:
SEWER UTILITY
PROVIDER:
WATER UTILITY
PROVIDER:
ESTIMATED COST OF CONSTRUCTlQN:
(EXCLUDING LAND VALUE)
meCA ~n~
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
'20,1 e
x
o POST &
BEAM _PIER
Lot Split:
SLAB
o BASEMENT (WALKOUT:_Y---,--N )
,
For Single F~iIy and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences wi~ 180
days of the date of issuance of the building pennit, and must he completed (Certificate of Occupancy issued) within 18 months of the issuance date. S:lass 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 LC. 36,7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, floor drains are connected ~~~~~ary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupancy as. e . uedbYth:De lmJ:L.:mmUnitYServic""carme~ /VI. i\'IvstfdL l/'Z/Or
Signature of OWner 0 thorized Agent Print Date
OFFICE USE ONLY. *********************************************** **********************************
~CTIONS REQUIRED:.' Filing Fees: /'O? /0 ,
Base Inspections: .?- -;? /. .)(/ # Charged Re-
ReVIews
Cert, of Occupancy: ...,3 -:.V
~~.l.r.. !j!<Lcf~L~ala
TOTAL:
~vp
I
Additional Fees
I
Fee Received
Date