HomeMy WebLinkAbout07010020 Application
NAME OF lfTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT #'S (IF APPUCAB
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
8< PROJECT
INFO:
SEWER lfTILITY
PROVIDER:
City of Carmel/Clay Township Permit #: ~7 0 I OOl-.D
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, 8< Two Family: New Structures, Additions, Remodels, 8< Accessory Structures
NAME:
Bel/a! &v/VS'-r..el'/ . /LD ~
STREET ADDRESS:
g3~1 C-fZ-f4.1/;t ST =#/tJo
PHONE:
w<: ?17 - S<i r...q"
CTIY:
~b..,~,.n4-1'O"I::'
o
FAX:
~7-5<))- <a-;
STATE:
,JJ
ZIP:
BUILDER'S EMAIL ADDRESS:
SwtH k.e.' l.L"s+r~ ""-<..,.-ius. C.-II{
BEST METHOD OF CONTACT:
SUJrr mas "e
3/" ~7/" -OJ'2-
NAME:
PHONE:
'Sr? -s-~s--1" ').1
CTIY:
:7:"N/)"J.vAPt>/.-IS
STATE:
)f\!
FAX:
3/7-5'9. -2-I/.,
ZIP:
W6 ZS;-O
fU.4N" ,oj ..f I?'l If IIV ' I._.U:-
STREET ADDRESS:
%'~ g3 {].IZ.'IH" sr # /()~'?
lOT #: SUBDIVISION NAME:
13U1t.-/)",,;~ 4 - urr <.f-):.
ADDRESS OF CONSTRUCTION:
. 12- MA-/A/ $-r C;<J.ent&L
CameL
SECTION:
/}4(),vo,v i- nt4-F /II
ZONING:
1>V1:>
.IN t.4 2-i'2-
ESTIMATED COST OF CONSTRUCTION: Jl. Q. !...~ ?I 000
(EXCLUDING lAND VALUE) l) ~, _.,. -
'PrIll l2F-hMII; l:lt
/.-~ 7 'D b 0 ()7~ :JS
2-"IIIE L.;.. 070100[efL TAXMAPPARCEL#: i''-o1-z-r-01-t>3-C2.0.'
>< /' i6 -01-2-. -02..-1) -- U.
TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
&J NEW~ ~o,~,~ pt..j)~eilv4-
~ ROOMIMiioj~Clilmpliance Pvl~in itKallltate License #:
o PORCH ADDITDJ \llIn a I rM,y1ati
o DEC~~~~ Ie and Local rQg~.r ~ i'1~ 00 13 ('"'"
o RE~ . .COMMUN.t~&eJ!liYIet'Swillbe'PPliedtOtheconstruction: ,
o ACcESSORYBU~WI~l / ~'1'Cl~~l'.i!dential Code w/Indiana Amendments
o DETACHED GARAGE INDIA"Hh. II" .
o ATTACHED GARAGE "1<\) Uniform Plumbing Code w/Indlana Amendments
o DEMOunON
WATER lfTILITY
PROVIDER: C./tWZ1"1. E: t-
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
e TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Addition.. Remodel.. Etc.)
A-Y)(N
-Y.{SLN
FOUNDATION TYPE: (Check all that apply for the new
construction area)
PROJECT INFORMATION:
Earty Release
Permit:
Lot Split:
Manufactured
Trusses:
Sump Pump:
~Y_N
_Y$N
o CRAWLSPACE 0 POST & _ BEAM _PIER
~ SLAB 0 BASEMENT (WALKOUT:_Y----,-N )
For Single Family and Two Family dwelIings, 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 permit, 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 CAC 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 I.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, ba~. 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 be issu;d by the Deparflent of Conununity Services, Canne~, Indiana. j J _ J......o""\
Vi :- VI). h)~ ~ tv!, I'^C/tf.tf--rL- ~
Signature of Owner'l Authorized Agent Print Date
OFFICE USE ONLY: *********************************************************************************
~PEcnONS REQUIRED: Filing Fees: . ~ r::: 5,..-,C (J-
U F. L F t- U Base Inspections: ? '1'7 ,v . # Charged Re-
pper 00 g ower 00 mg n Reviews
~c _ "i ~Cb_) Cert. of Occupancy: ,53, 50
Rough n ~e.er .,.se 'ite _ A:Jr-(lEd.v, v_ ~-'
'I'.IU.F.. _r ~ [Cpa Additional Fees
,_.~_ <_, ~~~~~~ t' 8Yt to..