HomeMy WebLinkAbout07010019 Application
NAME OF UTIUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABL
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER UTIUTY
PROVIDER:
City of Carmel/Clay Township Permit #: <' 70 I DOl1
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
NAME:
PHONE:
FAX:
3J~ - s<Js- - 2-ct I
ZIP:
STREET ADDRESS:
JO k'~ LR4-'
CITY: STATE:
';C#b/4N4PUI III
BEST METHOD OF CONTACT:
-5lo Hle:fI.
-J,17 -71<{ - $'7P
BUILDER'S EMAIL ADDRESS:
5M(l~J.w @ il
NAME:
1'Yl4J/!AN' f-n14/IV ~
STREET ADDRESS:
t3fj?, U!4'& ;sr "# liJ(.)
PHONE:
'3/7 -~"'S-- P'1S-
em:
Zov)>'41'14I"OU S
FAX:
3;7-S-1r-j!,lbl
STATE:
IN
ZIP:
-N,Z'-sO
lOT #:
81,)11:-/)1,.16
ZONING:
fr/7>
SQUARE ~ '71
FOOTAGE: ~..c:.
SUBDIVISION NAME:
- UrT
tiC
SECfION:
j'J1(1A/()"'/ f- MI!/#
ADDRESS OF CONSTRUCTlON:
1.116 W M//I# $,
~CL..
"N <112--~ 2-
1;
ESTIMATED COST OF CONSTRUCTION: .tl _. , - .. .I 00 e>
(EXCLUDING LAND VALUE) ~ _
j,VJU.':, ex~J4.I/J4 -n,v ;>1/1> 12EU>~c t>e
"b U # t> . Q) 6<1. 7"
:l:t0'70 160cqA TAXMAPPARCEL#: II..-oq-zs-oz.-o:s-o
il,,-"'l-U-C"l..-C"l- 2. . ",'
TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
tiJ NEWSTRucrURE ~ '~..j.- ~ 'PUlIYtIJ.,,v"t
o ROOM ADDITION(S) Plumber's Indiana State License #:
o PORCH ADDITION(S) .
o DE~~ON(S) CP f<EFl:>n I"?<'
o RE~'MS~QsfQJy Co Which plumbing codes will be applied to the construction: .
o ACCESSOR~ ~J!l~nce .~f""'- Residential Code w/Indiana Amendments
o ieDfi.- WI {/';~-""1"/Ul\r
o ~""" and Local UllItlRIIatll!llmbing Code wI Indiana Amendments .
o ~"vUMMUN Odes
~~ARMEl fry "Qt~N TYPE: (Check all that apply for the new
Manufactured J / CLAY'i"~ rea)
Trusses: &v NQlANA t!!PliJJwLSPACE 0 POST & BEAM _PIER
Sump Pump: _V ~N dfj) SLAB 0 BASEMENT (WALKOUT:_V---,-N)
I
WATER UTIUTY
PROVIDER:
(A.eWtEL
FLOOD ZONE AREA DESlGNATION(S)
FOR THIS PROPERTY:
21> " E:
x:
TYPE OF CONSTRUCTION:
i SINGLE FAMILY
TOWN HOME
TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release h-, V
Permit: ~V AN
_V-@N
Lot Split:
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences wit!nn 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 beginnfug and
completing construction. I
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"1(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 diat only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Cerrificate of,
Occupancy has e i ed by the De t of Community Services, Carmel, Indiana.
~ti'r'r ftI. M~tfg(l
Print
I /-z-/;) "1
Date .
OFFICE USE ONLY: ******************************~~**********************?*************************
~CTIONS REQUIRED: FIling Fees: f., O? /0
. . Base Inspections: 277. <0' # Charged Re-
Upper Foot, Lower Footing n ~ - //1 Reviews
c9 "' - Cert. of Occupancy: ..::. ). ,) U I
ough I ~erJsase . AI O;:::ld.. ~',J
'- "~CL' 'f',I'U,I'.. 71lr~~ /,~JY Additional Fees
VA ~;rmAL' ~R/(l
Reviewed/Approved: Dept. of Community Services (Date) ~~.....--z _~__
S:Permits/formS/IlP RESIDENTIAL eCewe ~ Date
Fee R ed by: