HomeMy WebLinkAbout07010169 Application
City of Carmel/Clay Township Permit#: 070) Olb~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
)ER
,-,
~CORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
NAME: R.A L(J e V)Ml2JJ C~+ I (j\) V,"HONE:
STREET ADDRESS: ~ 41. q B Ll1 If C-e.DClc O~:
I~ ~y 63~~
CiWLrn 6L--
STATE: J0 I
BUILDER'S EMAIl ADDRESS:
F2-'\W j.') e, (\ lffiT20 811J6, C6YII
L~~ ~ i() ~+,00v,
~L~ 8C4 e CtU5l>\L [)fL, CITY:
s~o~ t WJl,v~ Cf21)L,\L'ON
ADDRESSOFCONSTRUcrrON b\9 ~ WWJ sMV LG\~( Ofl-I
/1 2 y~~~
mUG
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
SEWER UTILrTY f' I .I n \ ,\ r\ WATER UTILrTY (' f\J),^-
PROVIDER: ~ IL.~ PROVIDER: \...II1y L, I' lfl-,
NAME OF UTILI1Y EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL ANDIOR SEPTIC PERMIT #'5 (IF APPUCABLE):
00 k:....
JJr~v Dn0VO~~1
\10
FLOOD ZONE AREA DESIGNATION(S
FOR THIS PROPERTY:
JAN 2 5 20m
TYPE OF CONSTRUCTION:
~
SINGLE FAMILY
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:
_V..,&N
_V-j4-N
TYPE OF I
~
o
o
o
NEW STRUCTURE
ROOM ADDITION(S)
PORCH ADDmON(S)
DECK ADDmON(S)
REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
Manufactured
Trusses: _y){LN
Sump Pump: -iJ-v _N
TAX MAP PARCEL:'#:: 'I;
"I' "
" 'I'
III J.
'II "
PLUMBING CONTRACTOR:
.s CkJ (A Wi.... R L()tl1 BUS) (]V.J /
Plumber's Indiana State'L1cense #:
$? g J 0 [S-d1lS-
Which plumbing codes will be applied to the construction:
o International Residential Code wI Indiana Amendments
~ Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYP~: (, eck all that apply for the new
construction area) f-CUI\
o CRAWLSPA 0 POST & _ BEAM _PIER
o SlAB BASEMENT (WALKOUT:Lv N)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory...~~U1Fl';!,J;.e~ht~s rmf~~~;JJiA" y' fPBmHS!ffRifl'ltammences within 180
days of the date of issuance of the building pennit, and must be completed (Certi~d:d 'W.'&4r.~lh~ m ntRsoTih-e-issuance date. Class I
structure pennits are subject to the General Administrative Rules of the State of Indiana (SeeOtr . :t}rr8t~g.e . ,.:'\ time frames for beginning and
completingco",~ nF COMMUNITY SERVICES
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation~nlter'atiOn of a struc. ture, qr},W 'iNP&f-~tqe,/r,l~'H)i Wt4 or structures
requested by this application will comply with, and conform to, all applicable laws of ~~e 6DlTidGAiiM:it:zh~in~VM1~mlniana - I993~ (z-
289) and amendments, adopted under authority of LC. 36-7 et seq, General Assembly of the State of Indiana, aq~,tM2S.Nl!fndatory thereto. I further certify that only
kitchen, bat and oar rai are nn t to t e anitary sewer. I further certify that the construction wII~l.'lrt'lk'hsed or occupied until a Certificate of
ocf!I\- ,ens by Dp' entof ommUnitYServices.c~,~~an!-, A~Q.O PR-u.JOJ-7~--{(1)
Signatu~ o\g t Print j.9 \ Date
OFFICE USE 0 Y: *******************************.~********************i***~*~*;;;D*****************
INSPECTIONS REQUIRED: FIling Fees: , ,~rd-, ,
<\leper Foot~ower FOO~ Under Slab Base Inspections: ~ =:.- 3 ~
~ Cert. of Occupancy: 0 3,...)
~'~ter B~ Site, P.R.I.F.: / d-... (; / O()
# Charged Re-
ReViews
Additional Fees
.90