HomeMy WebLinkAbout07010016 Application
~CitYOfCarmel/Clay Township Permit#: rYl0/'DO/h
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
NAME OF lJTILIlY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNn' WELL AND/OR SEPTIC PERMIT ,'5 (IF APPLI
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER lJTILIlY
PROVIDER:
NAME:
PHONE:
/tvt.. 3)7-.J9.)~'}p9r
FAX:
3/7-r'1J~ -~I"I
ZIP:
</--6 :t.Sl>
CITY: STATE:
-:f:N/)i;HVlffPN..-lS ,/N
STREET ADDRESS:
2r~ 2 ~ OZJ!iIt't sr :# 'dO
BUILDER'S EMAIL ADDRESS:
BEST METHOD OF CONTACT:
"'" Scr7T MPSHi::t€ "Si 7 -'7/,/ -S- 2-
PHONE: FAX:
:JJ7--0J--,,,,r 3n-s-'9~-2.I'/
NAME:
/'1 ()IV P.rl/ V' /?'1/1-/ A/ L-L- C
STREET ADDRESS:
'Y S lr.? c.e I'fl 6 :rr '# 1c:1O
CITY:
:;t;N i:> J 4iV J'f Jl'C U J
STATE:
u'l/
ZIP:
zs-o
lOT #:
SUBDIVISION NAME:
U7 31+
ZONING:
PUP
SQUARE ::z ~ tll..;2.
FOOTAGE: ~~
1t fi" 6'6lj-o"
,
1>\10 ~N .-'
, t7tP "<le7ocJs-z....
TAX MAP PARCEL': i6 --0').. 2- ,-Ol--O! - P2l>,':
i" - '. 1>2 -02.1 .
II
SEcnON:
J'U#IV,II/ r-ntAhV
ADDRESS OF CONSTRumON:
)//.0./ 3ak
~El-
462-32-
AVE
UJ
~EL
ESTIMATED COST OF CONSTRUCTlON:
(EXCLUDING LAND VALUE)
WATER lJTILIlY
PROVIDER: C4Il-mEl-
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: f\'11
Q SINGLE FAMILY ;(; NEW STRUCTURE ~l'I~tJv'1
~ TOWN HOME 0 ROOM ADDITION(S)
o TWO FAMILY 0 PORCH ADDmON(S)
# of units being 0 DECKADDmON(S) N ~ g*'S'PD IU"
constructed at this 0 RE~~~TRUCTIO . . .. .
ti se..... '"Fr . . ,WhiCh plumbmg codes will be applied to the construction:
me: REI ~^ L.<..!...O n !m~PI\lJl!l.tlon5A
o RESIDENTIAL (For ':'t;r\~IiR ell /11- ~ International Residential Code wI Indiana Amendments
Additions, Remodels. EtSIlIbJ9Ct R!1~...GA~ es.
t Ii ~ERV\CEg:J Unifonn Plumbing Code w/Indiana Amendments
PROJECT INFORMATION:DEPT @f M~~.fC~Y TOWNS\-\IPFOUNDATION TYPE: (Check all that apply for the new
Early Release CITY Qia~~Urelh\~ construction area)
Permit: &Y _N Trusses: \I'IU '(l:jLY _N 0 CRAWLSPACE 0 POST& BEAM_PIER
Lot Split: _Y f3j-N Sump Pump: _Y AN tj) SLAB 0 BASEMENT (WALKOUT:_Y-+N)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is valid only if construction commences wi~hin ISO
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 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, bat d floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupanc asbee 'ssued by the f.e~ar~t of Community Services, Cannel, Indiana. I J
s;...tu.. 0 / ne' :"thO~ ~.~!^-' Il.....-- Print 41..oIT tVl. "" ~ fht:- Date l, ", 0 1
OFFICE USE ONLY: *********************************************************************************
IN ECTIONS REQUIRED: Filing Fees: 6//. r2 CJ
Base Inspections: " '7? ,,0
C/
Cert, of Occupancy: <73. SO
"""'..~~fo/A";~'-
Fee Receive . Date
2-oN t .lc::
PLUMBING CONTRACTOR:
';2+ rZ Pt..//rJt.t:11I! L,
Plumber's Indiana State License #:
# Charged Re'
Reviews
ough In .
\~l~~
Reviewed/Approved: Dept. of Community SeNices (Date)
S;Permits/Fomls/ILP RESIDENTIAL