HomeMy WebLinkAbout07020021 Application
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
SEWER lJTIUTY
PROVIDER:
City of Carmel/Clay Township Permit #: ()7()zaJ11
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
STREET ADDRESS:
NAM~dLQl"(A. LClrlCl PHONE:Lj I 504
Kd UlltL\.n @:rrd/liJvl.. ~rdd
55: CS\lo "Z.\ooSVLlle ~
NAME:
PHONE:
STREET ADDRESS:
CITY:
lOT #: d.d SUBDIVISION NAME:M5S -t6
ADDRESS OF CONSTRUcrrON: 3'eJ 1 S Pr ro re
WATER lJTIUTY (l e
PROVIDER: u\0rY(Y)
SECTION:
I
ZONING:
SQUARE
FOOTAGE: I ~
ESTIMATED COST OF CONSTRUCTION: ) \
(EXClUD!NGLANDVAlUE) ,to ~
NAME OF lJTlLTTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 I PUCABlE):
.# 0'7D2Cx:;Wi?
~
FLOOD ZONE AREA DEsIGNATION(s)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:"" . TYPE OF.IMPROVEMENT:
~NGLE FAMIl~ ("' '. , .~ '-~i;y}\ STRUCTURE
o TOWN HOME' 0 ROO':i,ADDITION(S)
o TWO FAMILY, @ PORCH'!"DDITION(S)
# of u,nitS, being r: l'l _ 1 1(l't'J DECK' !"DDITION(S)
constructed at if,f5 0 0 REMODEL
time:' \\ \ \ \ "..__.-.--~'==- Base~ent Finish only
o RESIDEN-':IAL (For " 0 ACCESSORY BUILDING
Additions. Remodels. Etc.) 0 'DETACHED GARAGE
\ 0 ATTACHED GARAGE
\ -' .-" 0 DEMOLITION
PROJECT INFORMATION:
PLUMBING CONT
J) \ u. ('{\
Plumber's Indiana State Licens~
<6't~ O'\) \-:? .
Which plumbing codes will be applied to the construction:
.J>ktntemational Residential Code w/Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
Manufactured
Trusses:
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM _PIER
o SLAB Iii BASEMENT (WAlKOUT:_Y N)
Early Release
Permit:
Lot Split:
Y~
Y~
Sump Pump:
vY_N
l/Y _N
For Single Family and Two Family dwellings. additions, remodels. and/or accessory structures, this permit is valid only if construction comme c within ISO
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy iSSmmed) wit' ~ i . dass I
structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 . i , ing and
completing construction.
!, the undmigned, ageee th" any construerion, reconstruerion, enlargement, eelo,,:ion, or al:m:ion ofCer , or any c ange in the u," of land or ,truccures
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 - 1993~ (z-
289) and amendments, adopted under authority of r.c 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 are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occup cy has be,en issu by the De artment of Community Services, Carmel, Indiana.
OFFICE USE ONLY: *************************************************
Filing Fees:
Base Inspections:
Cert. of Occupancy:
INSPECTIONS REQUIRED:
Date
::;2." ;)-01
*****(5*******************
,0
--217'7,50
53, c;;D
I, ~6/(OO
/
Additional Fees
ower Footing'
Under Slab
# Charged Re.
Reviews
Site .
P,R.I.F,:
"".'-0
Dept. of Community Services (Date)
S:Permlts/formS/ILP RESIDENTIAL