HomeMy WebLinkAbout07010015 Application
City of Carmell Clay Township Permit #: 07() I () 0/[5
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
NAME:
'B/Z~ve' 4o,ll..'(N:. ~\)iv~S, r~&
PHONE:
111' ~"l5"- "10115'
FAX:
:J11-":J~S-2-i
STREET ADDRESS:
$]-% 7, c:;P-A.14 "ST. .tIolOc:>
OTY:
.t-...h i'lIJA!>o'-'/.r,;.
STATE:
T1-J
ZIP:
ifbZ<<;D
PROPERTY
OWNER:
BUILDER'S EMAIL ADDRESS:
t;i'l,O,\.ey
NAME:
v; J..~.;. t;'H"\.
BEST METHOD OF CONTACT:
1vI",,,tML- 3/1,'7/' -Sfez..
cJl-/I.lt{ ~. it(Vp
PHONE:
~r7 - <)q$' ''''10''1. $-
CITY:
FAX:
5/1-<;'7."-- 2{lP
MOAl"^, -( MAW. i./.-C.
SUBDIVISION NAME:
MOl>>O,V ~ ItIi\W
SECTION:
.oJ ^
ZONING:
LOCATION
&. PROJECT
INFO:
STREET ADDRESS:
~'19
LOT #:
'j~
STATE:
ADDRESS OF CONSTRUCTION:
~\-Z ~ MM.u qr
cPc{l.MeL.-
~,.J
t.f:b 2-7 z..
SQUARE
FOOTAGE:
SEWER lJTILTTY
PROVIDER: G4{lWI~
WATER lJTlLTTY
PROVIDER: PA~I\1..GL,
ESTIMATED COST OF CONSTRUcnON: L
(EXCLUDING LAND VALUE) "'l'" Sf ,-_....
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSIDN / BZA / BPW DOCKET iu ivv; e)(l:AvlI"(1.h( P"D ~.>e' 'j)o~T
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT #'S (IF APPLI LE): bP A~ D~ ~ 04:0\<03 o1!:o,UO?
FLOOD ZONE AREA DESIGNATION(S) V :#07&100 u I TAX MAP PARCEL #:it"oq -2/,;-UZ-O]-"'20_ &:><>:
FOR THIS PROPER1Y: 1-0 pJ I? /" ~I 1/(1 '",<-2$ -02 -e.>'3 -v'Zt.
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
o SINGlEFAMIlY A!;oNEWSTRUCTURE\I1 '.""'*' ~i,f2- PIAl.....!'>1 p~
~TOWN HOME ~ ROOM ADDITIO!l(!i) ~ l Plumber's Indiana State License #:
'tJ TWO FAMILY 0 ro.~OI..f\[\I'fn(j)Q6) /J ~
# of units being """,4l'.(!IIali<'AIj'jb'IYJ~~ (/r~ 0' /3-,
constructedJl~ tlIi5S"'O Y-=-. r tl R....0lIl1ll?9
time: 'R.t:.\"'t:J" ~COft'\.p\\ance ='e~nt Finis.b. only Which plumbing codes will be applied to the construction:
o RESIDENTIAs(l!l\l!Ict to \e anCoUA~.J;.!i~~f#IJ-\fLblllG @)International Residential Code w/Indiana Amendments
Additions, Remodels. alJl\3COI'Af;AUQill'At _ ;~l/,lVIliIl!r\\P 0 Unifonn Plumbing Code w/Indiana Amendments
EPi OF :'Ci I+TI~EDGARA"Gt .
PROJECT INFonQl;-nalll.CA.r.\lfltfu DEMOLITION
~. \ND\!\Nf\
Early Release If:;) Manufactured ff:r.
Permit: \;J'L-Y N Trusses: \2:i-Y N
lot Split: _Y ~N Sump Pump: _Y ~
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM _PIER
'@SLAB 0 BASEMENT (WALKOUT:_Y_N )
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 pennit, 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 Cannel 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
kitchel?, bath :floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupancy; as been' ed the Dep . ent 'fC}mmuruty Setvices. Carmd. Indiana. . / ;'
'. I ~ ,"WT[ tv1, M~ I z "1
Signature of Owner or uthorized Agent Print Date ,
OFFICE USE ON L Y: * **** * * ** * * * * * * * * * * * * ** * * * ** * * * ** * * * * ** * ** * * * ** * * * * ** * *.* * * * **** * * * * * * ** * ** * *** * * *
IONS REQUIRED: Filing Fees: e: 7--1. '71} . .
Base Inspections: ,-:;2 ? 7 'jij # Charged Re-
Reviews
Cert. of Occupancy: 5 ,? 50'
P.1U.f.. ~(~~ . Addltlo~al Fees
~7~T~L:/1 t:?~ 3.0;
~~ Jd'~ .
Fee Receive Date
pper Footin
Site
ReViewed/Approved: Dept. of Community Services
S:Perm!tsJFormsfIlP RESIDENTIAL
(Date)