HomeMy WebLinkAbout07010046 Application
City of Carmel/Clay Township Permit #:~
,
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:
11:i~ W'':'c>ow in7/0~Ot)lS
PHONE:
5-'7'1 -10300
FAX:
5-7'1 - c.,. t) I
STATE: ZIP:
CITY:
~ \r ..:L:;...\
ST METHOD OF CONTACT:
fhu
:IS'O
,..r 1t
PHONE:
'34J.. -/rl;).
FAX:
CITY:
c.w.l'>Ill
ZIP:
'-/&'03.
ZONING: S _I
STREET ADDRESS:
(gO;;!C E /I .1/ '3.,
STATE:
IN
LOT #:
SUBDIVISION NAME:
SEmON:
SQUARE
FOOTAGE:
ADDRESS OF CONSTRumON:
l..O::lc.
SEWER UTILITY WATER UTILITY .;
PROVIDER: S' PROVIDER: '(e::1.
NAME OF UTILITY EX ATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S) V
FOR THIS PROPERTY: /'
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
9( RESIDENTIAL (For
Additions. Remodels. Etc.)
;6
CONSTRliciioNl3
liliE)~ :,. ::'. O:QOO
<>.' ;--: . .~"... __ - ~ -~,I, ,
i\i
..j \ H
f\ i ~ i I' I
,H
,
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VNSHt1~e:D
"Ii}!
II ~~\ I
III Ii!
TAXilru1RCEL ;
I 1___. ...._
TYPE OF IMPROVEMIitfi: PLUMBING CONTRACTOR:. ' _
o NEW STRUcrU~I"lt:LE:ASE:D F L -- ...,.u. .""
o ROOM ADDITION~eCI 10 Corrfrl~et!()i'I!l@RState License #:
~ PORCH ADDIT~N(S) of SI PIIf1nce 'd'U / IiUCT./O
o DECK ADDmddl!1P>r 0 ate "'Jd L With all "e N
o REMODEL CI7"y.r..r::.! C0l\l111ch p~\i,'IIi,(g~9":;liY@8liI>Iied to the construction:
_ Basementl'ih'5aJU'uA 'V/(j/V/7v -=.
o ACCESSORY BUILDING AMf;;L ~~l"'~f1o&if~l!.tial Code w/Indiana Amendments
o DETACHED GARAGE JA<r>, . lAY :r'"'h1_~~ .
o ATTACHED GARAGE ''''='I,~~~mr PRltUTVI"ISFliI w/Indlana Amendments
o DEMOLITION FOUNDATION TYPE: ~~heCk all that apply for the new
construction area)
PROJECT INFORMATION:
Early Release . / Manufactured
Permit: y ~ Trusses:
- - ------
_Y ~ump Pump:
Lot Split:
~
o CRAWLSPACE ~ POs:r&_~;;B\M_PIER
o SLAB 0 BASEMW: \(/ALKOLIT:_Y_N )
~~
For Single Family and lWO Family dwellings, additions, remodels, and/or accessory structures, this pennir iz, vaiio. only if construction commences witJ:rin 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. qass 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, enlargemeri relocation, or alteration of a structure, or any change in the use of land or structures
requested by this application will comply with~nd conform to, all applicable ws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana - 1993n (Z~
289) and amendments, adopted under au fu-lty of I C 36-7 et seq'r:e ral Ass mbly of the State of IndIana, and all Acts amendatory thereto I further certify that only
kItchen, bath, and floor drams con cted to the samtary sewer I rther rufy that the constructIOn WIll not be used or occupied until a Certificate of
Occu y h e u the epartment t Commuruty S ces. el. Indiana .
'"' . a-e./.,.tJ j-,j-tV7
of Owner or A 0 Age Ont
'- .
OFFICE USE ONLY: *********-******
INSPECTIONS REQUIRED:
~g Lower Footing Under Slab
~Jl'~'
Reviewed/Approved; Dept. of Community Services (Date)
~Pe'm;"/fom1"ILP RESIDENTIAL
00"
************************************;r******************
Filing Fees: /5 JJ.? :
Base Inspections: I / ~ -50 # Charged Re.
I (7 ReVIews
Cert of Occupancy: ,;'3, 51
-
~
P,R.LF,: Additional Fees
~;t: 7~. ).?v
Fee Received by: Date