HomeMy WebLinkAbout07010139 Application
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City afCarmel/Clay Township Permit#: 0 7010/~
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:
NAME: i
VWCG ;:[",0 si'12k
STREET ADDRESS:
fSB cl?-Alti 91'.
PHONE:
l3v;/,<J:ZP.<; "TPc.
FAX:
3i7-~-Z;~1
.fZzs-o
~ 1-s--q~4VqS-
BUILDER'S EMAIL ADDRESS:
<::'MoS l"", ~ '
CITY:
if./bO y:-....t:>i<\,,vNbv{7
Abu: ld~v>;. tflM
STATE:
,.J
NAME:
BEST METHOD OF CONTACT:
s;., fo1.nAv.,- all
51., -7/<I-S7bz..
NI or5 b,J "1 MA ,,J I LVC-
PHONE:
317~S-&lr-'toq!~
FAX:
3;, - S15' - Vb I
STREET ADDRESS:
g~Y5 c.tZA It( ~. "'St{oo
CITY:
'PvbI4NAr..iA~
STATE:
:c.-l
ZIP:
4b ZfD
ZONING: pu.b
;z.
SQUARE .""1 ,
FOOTAGE:-- J "llf
LOT#lvb
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
KTOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions.. Remodels. Etc.)
PROJECT INFORMATION:
_YAN
_Y,'K-N
S:Permits/forms/IlP RESIDENTIAL
SUBDIVISION NAME: \ ...
TVlor-lDf" ~ f(!AuJ
SECTION:
ADDRESS OF CONSTRUcnON:
3e, <;;~ LA"!-€,
Cft(lM. €1..--
NAME OF UTIlITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
SEWER LfTIUTY
PROVIDER:
Early Release
Permit:
Lot Split:
elt~a.. , 'r",..1
;ft,Z3 Z--
WATER LfTIllTY
PROVIDER:
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
4; 170 OOJ
I
i,}1~ i?l(CA\lk'rt..l<f . /) {2e2.D~f!:i reI.
AJ::L.<; 1I:0401CO . D/fo1oo3S;2.-
TAX MAP PARCEL #: Ib-oq.-2S-<>2-- O'1-D"2v. 0
1'~lYt-2~-()2--D~ -02-t....c l>
TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
l;? NEW STRUCTU~ELEASED FOR corli6tfll(jc1f~N'''' 81'" f
o ROOM ADDITI~'~ect to co~allsAnl\il!lll"r!l~6l'Ill'e #:
g ~~~~~~~~~:: of Slate and loc~8"l>" i ~ S-
o REMODEL I?~PT OF CQl\fJ.!l,'..lIW~aS~eMl{;lij.$;ed to the construction:
o Acc:S~~;=,QJ!YCAR~J,WXaiTiGWMS!dlRde w/Indiana Amendments
o DETACHED GARAGE -V'-1r'lIAl\Il1. .
o ATTACHED GARAGE l'J 'DfflfoififPlumblng Code w/Ind,ana Amendments
o DEMOLITION
6A#1ia.-
"2o,s~
i(k'"'
Manufactured
Trusses:
Sump Pump:
FOUNDATION TYPE: (Check all that apply for the new
construction area)
'{ Y _N
_YLN
o CRAWLSPACE 0 POST & BEAM _PIER
-l!Q SLAB 0 BASEMENT (WALKOUT:_Y_N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is valid only if construction commences within ISO
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within IS months of the issuance date. Class I
structure 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 Cannel Indiana -1993n (Z,
289) and amendments, adopted under authonty Of~C 3 ,7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto I further cernfy that only
kitchen, bath, a 0 r drams are connected to the sa ry sewer I further certIfy that the constructIOn WIll not be used or occupIed until a Certificate of
OCClIpancy h been iss by tre ~epartten~ of nunuruty Semces, Carmel, Indiana t I
IM.. LMO Sl.D'\T ,^. I'\A.t~ fh:(L I ~I '1 _Of
Signature of 'zed Agent Print Date
OFFICE USE ONLY: ************************************** *******************************************
IN SPEC UIREO' Filing Fees: (a / 0 . /0
Base Inspections: .~ '1 f , 6:0
Cert. of Occupancy: 5"3 ' .5 0
rr~'/;o~1 ?8icl
TOTAL: _ 14-1 " 10
# Charged Re-
Reviews
P.R.LF.:
Addibonal Fees
Fee Received by:
Date