HomeMy WebLinkAbout07010018 Application
City of Carmel/Clay Township Permit #: 1)70 /D()~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER UTILITY
PROVIDER:
NAME:
U5 buA/S-rM
PHONE:
-s-err-
Sf ATE:
,tV
'/,t<&'(.
M 4/N L-I-t.
STREET ADDRESS:
83 ~~ CJz41
CITY:
IN N A-tV J'f('t71-. S.
BEST METHOD OF CONTACT:
"...
PHONE:
3" -' S-C;
CITY:
i>;i4#4-PtJUS
STATE:
/)./
STREET ADDRESS:
g~ S"l Ib
BUiLDER'S EMAIl ADDRESS:
5/'X/J'hw
NAME:
l'J/IOIo/D;,J
LOT #:
'E>UII.-bJAli':t
SUBDIVISION NAME:
- Ll!7
J3
ADDRESS OF CONSTRUCTION;
"120 fr14/)I/ sr
SEmON:
puAl/P1 fMJII/
L/~ 2-P-
(}J4bneL
W/US CXUWJ4-7'II.JtfJ
): ..... ,iL
v ~'~ ~
..., NC -J:/!67 en OO/t1L{ TAX MAP PARCEL #: 1j,-D'"I-7S-o;z.-O'?-O',l.<l, ""'<
.e;..D X R h ,.... - ,-0' ,..-0'1-0
TYPE OF IMPROVl!M&int to C :
.. gu <Uions
leD NEW STRU nd Loc ~ rWrvt8i,J
'0 ROOM ADD 0 1Ii!fU~-Il>~ense #:
o PORCH AD~F C v'l::" '1:1'-'1:::;
o DECKADDI'i'!dl'l(S)' ARMEL/CLJit.q~~I~<;
o REMOBDEL F' 'h I IN.jj;i.ft.p/Y~bing codes will be applied to the construction:
_ asement InIS on y /cia
o ACCESSORY BUILDING ~ International Residential Code w/Indiana Amendnients
o DETACHED GARAGE .' ,
o ATTACHED GARAGE 0 UnIform PlumbIng Code w/Indlana Amendments
o DEMOLITION
~EL
WATER UTILITY
PROVIDER: ~FL
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PU\N COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR CDUNn WELL AND/OR SEPTIC PERMIT #'S (IF APPUCA
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
TOWN HOME
TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release ,Iitt" V
Permit: ~Y ~N
_Y@-N
Lot Split:
Manufactured
Trusses:
Sump Pump:
(3LY_N
_Y~N
FAX:
ZIP:
17 -7''-1 - -7112-
FAX:
si7-S"l
ZIP:
"Iz.sV
ZONING:
l'UlJ
SQUARE ~
FOOTAGE: ...fi!PF7 2)
-~
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Base Inspections:
o CRAWLSPACE
~ SLAB
o POST &
o BASEMENT (WALKOUT:_Y~N )
BEAM _PIER
For Single Family and Two Family dwellings. additions, remodels, and/or accessory structures, this pennit 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 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, and floor drains are connected to the sanitary sewer. 1 further certify that the construction will not be used or occupied until a Certificate of
Occupancy n' ed by the D artme t of Community Services, Carmel, Indiana.
~ M , M.Q~fb;t2-
Signature of
Print
Reviewed/Approved: Dept. of Community Services
S:PermltsfFormsfILP RESIDENTIAL
(Date)
OFFICE USE ONLY: * * * * ** * * * * * * * * *** ** * * * ** * * * * * * * ** * * * * ** * * ** * * ** ** * * * * J*{} ,* *?f * * * * * * * ** * * ** * * *
PECTIONS REQUIRED' Filing Fees: (iiPI, /
271 so
Cert, of Occupancy: &,.3 . S-O
~,l.f,: " ~)rlil!f1,'d.
~TAl. ':it3.F
Fee Receiv .' ~ ~7:c(Z) d ," -~
Oate
t/-Z-/OJ
. .
w
# Charged Re-
Reviews
Additional Fees
I
/f) ,
Date