HomeMy WebLinkAbout07010195 Application
SEWER UTILITY
PROVIDER: t T fZ W I
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
City of Carmel/Clay Township Permit #: 070 I tJ I~S'
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
PHONE:
NOMeS ,31 75/" 9
MERJDI4;) .5n 3:>0
FAX:
,,3/7 Ylj>'lo1
~EALE.e.
STREET ADDRES~:
'0215:2 IJ
BUILD~'S EMAIl ADDRESS: .
TfY\U r I +I <<2Z b c..o. 'V:.r.
QTY:
TAIl> '/5
STATE:
TJ.!
ZIP:
~t2{P
BEST METHOD OF CONTACT:
COm
PHONE: /
.3/7509.35 3'
FAX:
.,,3/7 PIP'loll
NAbEftZ-Et.. !-10M E5
9~~DDd: I1E~/DMtI ..:51E30o
LOtT, #0: '1 SUBDIVISION NAME:
0'-- VillAGE of WC5TCLtiy
ADDRESS OF CONSTRUCTION:
r!).("'.:l:) ff/COTT 5r-erccE7
QTY:
-:r;...; D (5
STATE:
/-A./
ZIP:
'I~2t 0
ZONING: S ,
SECTION:
l, 00/
SQUARE , i
FOOTAGE: c:2 'f I"
WP.;TsoJ 6 ()
JAN 2 6 2007
:/
ESTIMATED COST OF CONSTRUCTION: /
(EXCLUDING LAND VALUE) / (pa
WATER UTILITY
PROVIDER: C;
SuO
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABlE):
11<...
()~ol
TAX MAP PARdEil! #: I ,
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION: <O~TYPE OF IMPROVEMENT:s. 'l2!.r:>, PLUMBING CONT~_CTOR: .
o SINGLE FAMILY ~ ~ G 'rsf NEW STRUCTURE Vb/Ii,c, i:::',~..j::ITt.j C/....,f-cj---,;--,SD,..J5
& TOWN HOME \0.X r!J' ROOMADDITIO~N( . '[CI1IU..mbers~ndia.na.StateLicense#:
6' TWOFAMILY . 'WI'" 0 PORCHADDITI ,0-,. o:,,-')'I!.,rty
# of units being V< 0 DECKADDITIO ' O","(Q.. .qo~ .frfJp' 9
constructed at this 0 REMODEL 0,., r r' : -:),.,./ '-f,//; , I/,j''r-... .
time' B t F' . h 'I' -"', ",Wh,ch plumbJng.:epdeWlll-be applied to the construction:
. asemen Inl5 any........ ->4,".<7 ....J; .,,.' 'VI
o RES~?ENTIAL (For 0 ACCESSORY BUILDING ""~?q:i~f~m~~~h;tbt{'~e~~~e w/Indiana Amendments
AddItions. Remodels. Etc.) 0 DETACHED GARAGE ~.'U "'f.." / ,.. .(/r," '>'/;/'<110-..'.
O ATTACHED GARAGE I,' " nl.!>.rm Plu,mb)ilg Co""",,,-' ndiana Amendments
I...hi '".,.1!,. oIe--...""l ~
o DEMOLITION "\:. 1 i' " "r
FOuNDATI heck all that apply for the new
construction are ~ .
o CRAWLSPAC7/J:) ~ POST & BEAM _PIER
li SLAB 0 BASEMENT (WALKOUT:_Y_N )
.,
il;
! ~
-..J
Early Release
Permit:
PROJECT INFORMATION:
Manufactured
Trusses:
Vy N
,/ Y =N
Lot Split:
_Y ~~
_Y~N
Sump Pump:
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences within ISO
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure permits 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 Cannel Indiana ~ 1993n (Z~
289) and amendments, adopted under authority of I.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
< :Zt;:h~?Department of Conununity ser~:~:T;it IM~a~~ i" J';} '-I 07
Signature of OWner or Authorized Agent Print Date
OFFICE USE ON L Y: *** ** * * * * * * * * * * * * * * *** * * *** * * * ~~ * * *** * ** * * ** * * * * * * * ** * *)*t!. * *1.0"* * * * ** * * * ** * ** * * *
NSPECTIONS REQUIRED: . FIling Fees: i? '
. . Base Inspections: c2r;; /. f(}
Upper Footon Lower FootIng nder Sla r- J.:;-O
Cert. of Occupancy: v
P.R.I.F.: /,). &-;10 ~dditionalFees
TAL: ' 2,;;2.;2 ? .C:;
# Charged Re.
Reviews
(Date)