HomeMy WebLinkAbout07010022 Application
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City of Carmel/Clay Township Permit #: ()7tJloo~~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
PHONE:
FAX:
3)7 -"qs-ut../
BUILDER
OF
RECORD:
NAME:
/!Ute br/I1IS-r.€J4 eVI
STREET ADDRESS:
~3 ~~ LlZIf'{:,
STATE: ZIP:
CITY:
;J:ivi:J/ RN 4Pt'j., S
BEST METHOD OF CONTACT:
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BUILDER'S EMAIL ADDRESS:
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NAME:
~;VCA/ I ml9-/l11 u..c-
PROPERTY
OWNER:
STREET ADDRESS:
8383
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Su-rT me s'
PHONE:
FAX:
317 -5"/j-2-/ I
ZIP:
LIt Z-~O
ZONING: /"(,/))
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If ItJ(I
I
cm:
7CPb/;44'4I*vJ.--1
STATE:
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57'
LOCATION
&. PROJECT
INFO:
LOT #: SUBDIVISION NAME:
;.111.-1>)/" b
SQUARE ,:::
FOOTAGE: fa _
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SECfION:
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ADDRESS OF CONSTRurnON:
1/0'1
SEWER lJTIlITY
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PROVIDER:
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{!AeJff.E2-
ESl1MATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
WATER UTIlITY
PROVIDER: ~E.I.-
AT/
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l>r
,-, _ #-070 I (9olR'6
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TYPEOFIMPROV~AS
~ NEWSTRU~~~ ia R~IN~
':0 ROOM ADDITION(S) of State ~ml3'C;S Iri lIa Ollense #:
o PORCH AD~~eq;bF ~ ill (.;oa~
o DECKADDCtr9'~J COMMlJNIiPf's~gi'2,~
o REMODEL F" Fh CIARMliib!bG.,"'..........,.Sol'Y~~~~Plied to the construction:
Basement Inl5 on y 1.:1"\T""] UVVro,J H
o ACCESSORY BUILDING IN9A.~!lli"ational Resi en al Code w/Indiana Amendments
o DETACHED GARAGE ,. .
o ATIACHED GARAGE 0 Umfonn Plum bong Code w/Ind,ana Amendments
o DEMOLITION
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEmC PERMIT #'5 (IF APPLlCAB
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
R SINGLE FAMILY
~ TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions, Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
~yKN
_Yfl-N
-If
Manufactured
Trusses:
Sump Pump:
FOUNDATION TYPE: (Check all that apply for the new
construction area)
GLY_N
_Y-@N
o CRAWLSPACE
{jl SLAB
o POST &
BEAM _PIER
o 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 permit, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
strucune 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 -1993n (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, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupahcyh ni, edbYth:Dro~onunUnjtYServiC",Carm~=aM. It-.."''';~ I (2.!O.,
Signature of Owner or Au orized Agent Print Date .
OFFICEUSEONLY:******************************~~*********************~~~~'*********************
~SPECTIONS REQUIRED' Filing Fees: . . -.&-f(J
F. L F t' Base Inspections: ;;; '/ .J ') 0 # Charged Re-
pper 0 mg ower 00 mg Reviews
~ Cert, of Occupancy: 53 JO
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Reviewed/Approved: Dept. of Community Services (Date) ~O~~
S:Permlts/Forms/ILP RESIDENTIAL Fee Re ved by: Date