HomeMy WebLinkAbout07010170 Application
City of Carmel/Clay Township Permit #:010' OI1V
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
AX:
3/7 S1/ /0 <is'
ZIP:
'(p 2 t.j ()
BUILDER'S EMAIL ADDRESS:
brtll1 @ CS, um
NAME: PHONE:
131? t/ IV S () t1I KtJ 11
STREET A'~SS tJ E Cf r;f-l1 Sf / I);Z~
NAME:
8f? UN .56!tl
STREET ADDRESS:
;0J'1:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
LOT#:
SUBDIVISION NAME:
0/;5
TE:
IN
BEST METHOD OF CONTACT:
FAX:
-S7j {)gLj/ (6
STATE:
oil . /I\!
g
ZIP:
SEmON:
CU.
ZONING:
FLOOD ZONE AREA DESIGNATIDN(S) 5'14 b,je.(...r rD!'e,-ry oIt'es nor TAX MAP PARCEL #:
FORTHISPROPERTY://tWl:thlil fhat5. i'C/tI//=/"t>d rd one" /7/30 OJ.O;l.tJOoOO
TYPE-OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
l6' SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
rI constructed at this
time:
RESIDENTIAL (For
Additions. Remodels. Etc.)
1
WATER UTlLIJX
PROVIDER: LA /' I/l e
NAME OF lJTILITY EXCAVATION CONTRAerOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
o ..-NEW STRUCTURE
-c;d RooM.ADDITION(S)
o PORCH ADDmON(S)
o DECKADDI;TION(!i), {~
..;;( REMODEL ~ ~{jR"
.T' _ Basement FiniSfonly
o ACCESSORY BUILDING
c::y DETACHED GARAGE
'~TTACHED GARAGE
PROJECT INFORMATION: /'_ 0 DEMOlITION
<::ra/'ttge. ~11 c./p.$t//? /
Early Release Mail'ufactured ~
Permit: _Y _N Trusses: _Y_N
Lot Split: _Y _N Sump Pump: _Y_N
SQUARE
FOOTAGE: S ;( 5'"
ESTIMATED COST OF.CONSTRUcnON;
(EXCLUDING LANDVA~~~i$' I;; -tJOcJ
" l
:"
JAN 2 4 2007
.i#/
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 0 POST & BEAM _PIER
C0"SLAB 0 BASEMENT (WALKOUT:_Y_N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is Vali.d 001 Y.if c onst~c tion commences within 180
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy iSSU~d. .. ~- s f the issuance date. Class I
structure pennits are subject to the General Administrative Rules of the State of Indian ~m ." frames for beginning and
completing co n. ·
I, the undersigned, agree that any construction, reconstruction, enlargement, re10cari re, or any change in the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of th ate 0 Indiana, and the "Zoning Ordinance of Cannel Indiana -1993~ (Z~
289) and amendments, adopted under authority of I.c. 36~7 et seq, General Assembly of the Stare 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
Decu eyhas been issue y th of Community Services, Carmel, Indiana.
/- Ki//J1i/(O 13tl.{/1So/J hJ3 -O<.otJ7
Signature of Owner or Authorized Agent Print Date
*****************
INSPECTIONS REQUIRED:
OFFICE USE ONLY: **************************************************************
Filing Fees: .
# Charged Re-
Reviews
Base Inspections:
Cert. of Occupancy:
P.R.LF.:
Upper Footing Lower Footing Under Slab
~h I~ Meter Base ~al s9
C . 1-2
~. eviewedjApp oved: Dept. of Community SelVices
.. ~'ml~/F"m'/ILP RES!DErmAL
Additional Fees
Date