HomeMy WebLinkAbout07010138 Application
\CifY of Carmel/Clay Township Permit #:~g
\
IffiSIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
.1r Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
6UILDER NAME:
OF '1?rz-UW Vl>l" 3v
RECORD: STREET ADDRESS:
8'5?3 if-l 0':>
BUILDER'S EMAIl ADDRESS:
~o>k2v e- t: ".. -/,,, : IJtV., . . _"\
PROPERTY NAME: 4 MA.'....) l u...c.-.
OWNER: t\1o"'~..J
PHONE:
'3/1- "" S- - 'f oer..s-
FAX:
sr1-57(c; -ZIt,. (
ZIP:
ZS-V
STATE:
BEST METHOD OF CONTACT:
~i"
-S-7ez.
PHONE:
5i1- S-q!) - qoqs-
FAX:
3i1-SQ5:- 2(bl
ZIP:
4b'2~
ZONING: pu b
SQUARE 1.7
FOOTAGE:
STREET ADDRESS:
~3S3 eP-A!4 .car. ;ttrro
CTIY:
J--i\:J)/,wA-l'ovi>
STATE:
'I"t-l
LOCATION
& PROJECT
INFO:
LOT#:
IZe.
SUBDIVISION NAME:
Mot-lo"! i MA(,..)
SEmON:
SEWER UTILITY
PROVIDER:
GAt-rIIet,
NAME OF UTIUTY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
FLOOO ZONE AREA DESIGNATION(S}
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
X TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_yXN
_Y~N
LA"':C CAIl-Mta. r,.)
Ifb Z ')2-
ESTIMATED COST OF CONSTRUCTION: .A.
(EXCLUDING LAND VALUE) cp /10 D 01:>
I
Wil-lh r::uAl/kn~ Puh ~:w.:l:(;: cl"!7T
b4-S -iF 0;; ot..{l11 CD 35"2-
TAX MAP PARCEL #: I' ~cf1.- 2S'-D2-V'? -,,-~, CC'"
,-'J_.\- "v"
.c-vr-~ "- i{,-O'\ -2.s--02 -,,:;>-~"Z-I...(1O
TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
...lc(" .&W~RUcr.UIl.E R "1 !2- Pw Nt 81 ,.)~
o 11tObIiiIA5ISJlD:0IWil e(JNSTI'!~~iana State License :
gS~~~f1lW:ewith all regulati&lf 3'8'8ov I~S-
O~D IJre ~~ti local Corl,,~
L.I~ b ~Mt9NVTV "Which plumbing codes will be applied to the construction:
OfTJl#:~d!t.ljI;qING...LA ~~onal Residential Code w/Indiana Amendments
o DETACHM)l;,\.'IUtcre I t; Y B fll~U.n, .
o ATTACHED GARA@iANA hl1iitrtlPlumbm9 Code w/Ind.ana Amendments
o DEMOLITIDN
WATER UTILITY
PROVIDER:
c-AA4It€L-
Manufactured
Trusses:
Sump Pump:
FOUNDATION TYPE: (Check all that apply for the new
construction area)
.x Y _N
_y~
o CRAWLSPACE 0 POST & _ BEAM _PIER
~ 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 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 structutes
requested by this application will comply with, and confonn to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Cannel Indiana - 1993" (Z-
289) and amendments, adopted under authority of LC. 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 ace connected ':jan~ary sewee. I further certify that the construction will not be used or occupied until a Certificate of
Occupancyh en" jdb theDep tme CommunityServic,",Canncl,Indima. . /
.. <;0>11' jVJ. MpS'th,)(. I ,. /1>.,
Signature of Own or A 'zed Agent Print Date I
OFFICEUSEONlY:*********************************************************************************
INSPECTIONS REQUIRED: Filing Fees: ,..z;- (as p {Q 0
Base Inspections: .;2 7 7, ~v
Cert, of Occupancy: .5 .3. SO
?\lZ.-v' ious~ r~ol Additional Fees
OTAL' ~ 816. toO
# Charged Re.
Reviews
(Dale)
Date
S:Permits/FormS/llP RESIDENTIAL
Reviewed/Approved: Dept. of Community Services
Fee Received by: