HomeMy WebLinkAbout07010137 Application
\
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
SEWER lJTIUTY
PROVIDER:
City of Carmel! Clay Township Permit #: ()70' 0137
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
NAME: PHONE:
'CtZ~ ti~,~T(lA tr>,v~ :f').)(;. 3i1-S-i.fS-1.oqs;-
FAX:
3/7-S1'S-~ ZIt? I
STREET ADDRESS:
., 8'3 CiZA 14, 91"'. it:-wp
CITY:
- ",1:1 '.v~.lfotA?
STATE:
.L-,J
ZIP:
4b2r;7)
BUILDER'S EMAIL ADDRESS:
~MoS~<lV Co
&,; {c(R.V<; . Cb,,,,-
gt7-71 -~7f32-
FAX:
Zr'1-9iC;;-- Zlbt
NAME:
Mo":>()).J i:J MAt.}, Uc..
PHONE:
3/..., - <;qS--- 4'0<1 S-
STREET ADDRESS:
8'3S:-j
LOT#:
1"Z-f::>
em: STATE:
bi~^Pb~I~ J;~
SECTlON:
ZIP:
Z<Q)
eMIt; Qr. i1:'(Db
SUBDIVISION NAME: ~
rtof-J(),J 'f MA'..J
ZONING:
pub
h
ADDRESS OF CONSTRUCTION:
s-f <;~ ~I\Ne
SQUARE
FOOTAGE'
C~ J:',J 462-'52-
UtUIla.
WATER UTILITY
PROVIDER:
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
~
j.u1~S ~~v"'T1"'i
.~
NAME OF UTIlllY EXCAVATION CONTRACTOR: PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPllCABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
-i1INGLE FAMILY
TOWN HOME
TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
_yXN
_y~N
Manufactured
Trusses:
Sump Pump:
FOUNDATION TYPE: (Check all that apply for the new
construction area)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
x. Y_N
_y--J.,.N
o CRAWLSPACE
o POST &
BEAM _PIER
~
SLAB
o BASEMENT (WALKOLIT:_Y_N )
For Single Family and Two Family dwellings, 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 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 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, bath, r d "ns are connected to the itary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupancy h by t~ D~part~e~t mmunity Services, Cannel, Indiana.
[II{. btl 4<J>1T M. JI1.~tf>,~ 1/11/0/
. I
orizecl Agent Print Date
OFFICEUSEONLY:*********************************************************************************
NSPECTIONS REQUIRED: Filing Fees: E: (as, ~ 0
Base Inspections: Q 7 7 . -5 0
Cert. of Occupancy: 53 . SO
P.R.I.F.: /1Jid. rre.-v';c::JtI..5j!d Additional Fees
TOTAL: ~ 31 (0. u 0
Lower Footing
# Charged Re.
Reviews
Reviewed/Approved: Dept. of Community Services
S:Permits/formS/ILP RESIDENTIAL
Date