HomeMy WebLinkAbout07020060 Application
City of Carmel/Clay Township Permit #: tJ 70 2tXJf120
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
PHONE:
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CITY:
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BUlLDER'S EMAIl AODRE~: II 01
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STATE:
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BEST METHOD OF CONTACT:
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PHSE; 7 . 9'1~ .r./S'C:o/ FAX: {'-.//&:".
STREET ADDRESS: CITY: , ,._._"STATE: ,,''":',''''~:;';,'}.'IP:;~..'.'''_'''
I ~37 7o<.JrMc./:iN /JC.s'il-;~dJ,~,. ". :..I.c~,,' ,VMF'/Y
SUBDIVISION NAME: :Dq1j~ . . 1\ ~....ie'" e&i8iC;,.J-L0G2 (zON!~ r. S
M. tv, /Kr"So'-';S Itzra.'mon 01 Str,~,e.,.:" 'h~r"{ SE'rf!!! "
,C :r. O;-~ v\./tV'"~<'- r pSQ"uAk . - --
CCAJ'f1^.e (~ ~#Li V FOOTAGE: c..; ,) 55 <p
PROPERTY
OWNER:
NAME: . / I
~i'v.."C.
fVl d..Udf
LOCATION
& PROJECT
INFO: ADD~S~r CON3CPgp: fI.v(:' tU.z.
SEWER UTlLTIY ( WATER UTlLTIY r (
PROVIDER: C c.J'~ PROVIOER: ~ f'\.t..
NAME OF UTlLTIY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET ./" G ,
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE): f\/;t r c," e "").POt(;!
FLOOD ZONE AREA DESIGNATIONJ!V + TAX M~ PARCF.k. # 7/\ c; (/ 1/1/ (JoO
FORTHISPROPERTY:L)Ot"S /Vel lie (,J,1tv'r...5 Ct',1 F(wJI!P.z.wJ7.""A- lif) -IU:.;u-Q /-07-0tN.' .
TY; ~~:;:=::NT: PLUtuG c~:/r:c;ORpftlt~b!:d~~~~;~:0. ";\ \':\
o ROOM ADDrTION(S) Plum~er's Indiana State License,#F/' 'l..()\Il '. ,\ ) \\\
~ ~~~~~~~~~~~\S) c '6 /O~ 1/ J ~\,:J,.\ "t,lQ ~ ~ ]:;:..;
o REMODEL ' ~ ~ \
Which plumbing codes will be applieCt to"the construction:____ ' -"
_ Basement Finish only \ \ \ '. \ '._____ ____
o ACCESSORY BUILDING 0 International Residential COile iY/IndianaAmendments.........-
\ \-. \...--- -~----
o DETACHED GARAGE 12' Uniform Plumbing Code w/Indiana Amendmen.s--
o ATTACHED GARAGE \ . . __---
o DEMOUTION -
FOUNDATION TYPE: (Check all that apply for the new
construction area)
LOHA, I (g
TYPE OF CONSTRUCTION:
at SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit:
_v.,KN
_YA-N
lot Split:
ESTIMATED COST OF C STRUCl1PN:
(EXCLUDING LAND VALUE) 'If cJ /0 000
Manufactured
Trusses:
_v LN
---LV_N
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB }Zl BASEMENT (WALKOUT:_V ~)
Sump Pump:
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 structures
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana - 1993n (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 are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupanc( has bee~ i"ued by the Dep"'tment of Community services;T:Jianac. . fVl o.f-fe -II J /0/0 7
Signatu f OWne;. or Authori Agen Print :J Date
OFFICE USE ONLY: ******************************~~********************$5******i*O*****************
INSPECTIONS RE UIRED: Filing Fees: . - J 1. fa 6
~ B I ct ,:< 7 7, 6' # Charged Re-
~ Lower Footin Under Slab ase nspe Ions: I ReViews
Cert. of Occupancy: S 3, ~O
,.....-Rough In) Site I I / I () ()
'---....:..../ p, R.LF.: 0
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S:Permits!FormsjILP RESIDENTIAL
(Date)