HomeMy WebLinkAbout07030008 Application
City of Carmel/Clay Township Permit #: 07a30008
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
f
FAX:
NAME:
STREET ADDRESS:
STATE:
I:
ZIP:
BEST METHOD OF CONTACT:
PROPERTY
OWNER:
PHONE:
FAX:
STATE:
J.-;U
ZIP:
6D3-z..-
LOCATION
&. PROJECT
INFO:
SEmON:
ZONING:
SQUARE
FOOTAGE: '500
SEWER UTILITY
PROVIDER:
~
OeD
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABUE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TAX MAP PARCEL #:
PROJECT INFORMATION:
Early Release
Permit:
_YLN
_Y~
PLUMBING CONTRACTOR: C1 ~ X k fe l"'-S fa (1-
;rJo,.,,- 0 t..J flax- I i 11a!.i.,. i'l ( ra.;lC-l0,..
o ROOM ADDITION~.. Plumber's Indiana State License #: ~ ^ ~ _) \j
o PORCH ADDmO~s. / ''>OU (Q
o DECK ADDmON(%.it. i'V-110 .
Iil' REMODEL t F' . h VUl1,..... (,{WIIIch .lJ.1iins.codes will be applied to the construction:
.v Basemen ~~'Sl Onlyq-'J'~.V:") .'::'VI
o ACCESSORY BU~J'i,G 's" ~J1tf!rh"i9ffal Residential Code w fIndiana Amendments
o DETACHED GAAA6f 71)6" '/J 'VO, ..:1f'v,/J1.r.... '
o ATTACHED GARA'GUO ' /II? ,J\:lliif~l/RIwl:)" Code wfIndlana Amendments
o DEMOLITION '171::/, 'if/""-,,.,?/)Ub. Uo .::10 ~~
-<StvotID.I~~~t~....~ all that apply for the new
Manufactured g.~0 om.> So
Trusses: _Y ~N . '&J. ~CiJvi~!6l 0 POST&_BEAM_PIER
Sump Pump: Ly _N '. .. ...CJ SLA~~)SEMENT (WALKOUT:_Y vN)
o NEW STRUCTURE
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
cE" RESIDENTIAL (For
Additions. Remodels, Etc.)
TYPE OF IMPROVEMENT:
Lot Split:
For Single Family and Two Family dwellings, additions, remodels, and/or accessoiy ktrUcf~!:.~;, ih!~:~}'~~' i~ y'~.ig o~y if construction conunences within ISO
days of the date of issuance of the building permit, and must be completed (Ce~!iCate~of Occupancy issued)witNP l~ I?onths of the issuance date. Class I
structure permits are subject to the General Administrative Rules of the State,oHndiana (See 675 lAC 12) regarding,expi~ation time frames for beginning and
completing:con"struction. ' ] ~ I! 1
t, the undersigned, agree that any construction, reconstruction, enlargement, relqdti69/or altMAAn afa iftru28.G7, or any:ch~~ge in the use of land or structures
requested by this application will comply with, and conform to, all apphcable law'sIJf the State of Indiana, a.nd the "Zoning OrBiriance of Carmel Indiana - 1993" (Z-
289) and amendments, adopted under authority of LC. 36-7 et seq, General Asse~bly of th~.~~t~~f}nc!~~.~.:..~!.ld ~1_A~an1e-ndafory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further cerl:;ify that the construction will not De used or ?ccupied until a Certificate of
Occupancy has been issued by the Department of Community Services, C~, In~~~~-"___^___ _ __'. __ _~__~ ._ _~._.J
H, aL y ./-1' ~Jlk l'l1/l{sf,;jJ/1er Ki;Acl / ~AY' 2=7
Signature of Owner Of' Authorized Agent Print ' Date
OFFICE USE ONt Y: *************************** ***~~*******************'*3**~a*********************
INSPECTIONS REQUIRED: FIlIng Fees: p _ )
. . Base Inspections: / / /. cJ 0
Upper Footmg Lower Footmg Under Slab ,
~ Cert, of Occupancy: , ):3. S- {}
~n Meter Base Final ~
J I ;j I. / P,R.I.F,:
M/L- !*'IV. ( /~AL'" ~ '/o'fdO
Reviewed/Approved: Dept. of Community Services (Dale) ~ ~
S:Perrnits/Forms/ILP RESIDENTIAL Fee Received by:
# Charged Re-
ReViews
r./O ?-dO
.~~
Date