HomeMy WebLinkAbout07010131 Application
City of Carmel/Clay Township Permit #: 61 O{ D! 3L
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:
STREET ADDRESS:
0'//6 #aJ..f
;.Ie
PHONE:
dY--FJ7J-I5-
FAX:
\$'-
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BUILDER'S EMAIL ADDRESS:
CITY:
STATE:
ZIP:
Gn, r~t>Y1' 1. 7NE'oo'g-tttlcO
fi- 51;'-ee-i
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
Nllv /{-e
LOT#:
SUBDIVISION NAME:
WATER llTIUTY
PROVIDER:
~ATE:
<_J,"'7 '
seCT10N:
ZONING:
. ,.SQUARE>Xfidaa
/ / ' ;j/ ,<-, FOqT~~~: -::', ,
/10_" +,....__.,..,...
ESTIMATED COST OF CON#RUcryON: -"'.:.:-:.::( tl 1'1 /;: >,
(EXCLUDING LAND VALUE) / //1 1.i ~ .~/' l,~:
I [., .......... ~(~,
,
ii
'-
'"
".
'-
1/<'00. :~/
.. . ,-/ '
~, --~l{(;j'
- ~
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NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT ,'S (IF APPLICABLE):
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
o SINGLE FAMILY 0 NEW STRUCTURE
o TOWN HOME 0 ROOM ADDITION(S)
o TWO FAMILY 0 PORCH ADDITION(S)
# of units being 0 DECK ADDITION(S)
"-,,nstructed at this 0 REMODj;k\~
time: ~ il"'ase'il(ep'~Finish only
o RESIDENTIAL (For CilC ACCES!iOii'IlUILDING
Additions. Remodels. EtC.).,? CCt:C~ 1l.ETACHED GA<~GE
....~ \,u" -8 -EJ' A1TACHED\~I(Rl\i. G~
C'"IJ ,'\?\\'-".....\OEMOI.fi'IDN' ,,'\t'
PROJECT IN A'TI N::'," ,\-<7-" t ,;:>,. ,y:;>\-\
~ v- '"'fIe. \\~ -'"q\~
Early Relea 5' \".:,\ec\ \{.;; {2;,,-?!.VJ c: 1,~"M~~irl:~c'tureJ.) 'I
Permit: ,VVI..p\ ... ~()\'J\'TrusSest" Y N
Q~I'~~~,\'\\4~t~p:P.f.np: Y _N
Lot Split:
,
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TAX MAP PARCEL #:
-'-
'--,
PLUMBING CONTRACTOR:
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
o International Residential Code w/Indiana Amendments
o
Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE
o POST &
BEAM _PIER
~SLAB
o BASEMENT (WALKOUT:_Y~N )
For Single Famil 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 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 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 Cannel 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
OCCUR cy has been issued by the Department of Conununity Services, Carmel, Indiana.
71t. ____ (jfl~ 1hO"'~5'J PUyr:[(1 1Y'e>vr:tJ(;/1[ if;/oJ
~~ I ~
OFFICEUSEONLY:*********************************************************************************
INSPECTIONS REQUIRED' Filing Fees: /3 -5 ' ,") 0
. Base Inspections: Ss I 6 C
Upper Footing Lower Footing Under Slab
GJ Cert, of Occupancy:
Final Site -
P.RJ.F,:
Rough In
Meter Base
I'!\
Revie ed/Approved: Dept. of Community Service
S:Perml /FormsjILP RESIDENTIAL
Fee
# Charged Re-
Reviews
Additional Fees
~ l'61 . ()O
Date