HomeMy WebLinkAbout07020121 Application
'fity of Carmell Clay Township Permit #: () 70 c2 f fa.!
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Stru~ures
BUILDER
OF
.. RECORD:
NAME:
Wi/
STATE: ZIP:
IV> &038
PHONE:
FAX:
7 - 97 S '1
cm:
STREET ADDRESS:
/U8D Foeo
BEST METHOD OF CONTACT:
BUILDER'S EMAIl ADDRESS:
317-'5RO-7 'NO
STREET ADDRESS:
, 3 'I e> ( vlcieT
PROPERTY
OWNER:
NAME:
LOCATION
& PROJECT
INFO:
lOT #:
i3
~i5 J..ic..GeATH
PHONE:
L/CjO - r;
cm:
G1e-lieL
FAX:
STATE:
iAiO;AI,Jri
ZIP:
SUBDIVISION NAME:
F.,c.u:i:: lie 10 t:sffiTf;,
SECTION:
I
C Agl.{eL
SQUARE
FOOTAGE: I
"cj:\
ADDRESS OF CONSTRucnON:
q7 a FAIAJI.) 'DR-n) ~
Ju
SEWER LJTILfTY . WATER UTILITY . ESTIMATED COST OF CONSTRUCTION:
PROVIDER: CiA '/ l!€.6fOIJ4{ PROVIDER: CitY Of CAeIiEL (EXCLUDING LAND VALUE) L/7(, )000.00
NAME OF lJTllm EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW OOCKET::It 070 /'
NUMBERS; TAC OAlE(S); ANOIOR COUNn WEll ANOIOR SEPTIC PERMIT #'5 (IF APPUCABlE). " e::zI?.4V If!:I'e
TYPE OF IMPROVEMENT:
}i!l NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL Which plumbing codes will be applied to the construction:
_ Basement Finish only >
o ACCESSORY BUILDING 0 Intemationa' Residential Code w/Indlana Amendments
~ ~~:~~:g ~::~: //--?i'uiiifom,-Plumbing Code w/Indiana Amendments
o DEMOunON 7 \
PROJECT INFORMATIO~: FOUNDA!lON liYPE: (Check an that apply for the new
, . construction area)
Early Release ~anufactured I _____'.. /. / I
Permit: _Y,N /.Trusses: 0=N] O/CRAWLSPACE 0 POST & BEAM . PIER
~ '1.() / / - -
Lot Spilt: _Y _N Sump Pump: \ _N h /9-"SLAB j1( BASEMENT (WALKOUT:_Y.-t'::N)
For Single Family an.d Two Family dw~ll~ngs, add~tions, remodels, an~cces~:;:'~ctur~, this per:rrut is val~d ~nly if constructi~n ~onunences within 180
days of the date of Issuance of the bmldmg permIt, and must be completed"(Ceruflcate of Occupancy Issued) WlthmJ,Q, f'\~\(i)\"lk Issuance date. Class I
structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC l^~ ~1~h6~ ~es f9r beginning and
completing construction. ~O'r\ Li"V\'ll.-. ~\ reg\); e:
I, the undersigned, agree that any constructiO. n, reconstruction, enlargement, relOcatk!:Q,,41rldtit&i6Q~a s . ~~~~~::n the u~~land or structures
requested by this application will comply with, and conform to, all applicable Jaws O~~!rl. '. \~\iiQ~\O~ Indiana - 1993" (Z~
289) and amendments, adopted under authOrity of LC. 36-7 et seq, General Assembly ff;,g\i)~~ 0 I~W-,.. ,1\I\~f~\!ifI<<~'lJle~~\.UMilher certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the co ct}qo'Wln$~'\I~~ ~~~'~.Certificate of
Occupancy has been issued by the Department of Conununity Services, Carmel, Indi~\ Or \.J €.\... ,: C
. '. . - ~' 1</<11& /3;/1 ,,9~.mscf>S:"~'I-\f)\P.NP. Z./Z1J/;lg(D7
Signature of Owner or Authorized Agent ~rint ~ . Date '
OFFICE USE ONLY: ***************************************************i'IC***
. INSPECTIONS REQUIRED: Filing Fees: / 0
L F t' Base Inspections: :+ 17 ")0
ower 00 mg nder Slab E:
Cert, of Occupancy: ~c;3. ..) 6
I r1- G!. ()O
TALl,,;, #'--2 5";(. ~d
p
FlooO ZONE AREA OESIGNATI N( )
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
"i!!- SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions, Remodels. Etc.)
xL un 5 Itadd.)
TAX MAP PARCEL #:
PLUMBING CON:rAAcrORiB L
.; i! ~. ..
E/Js AHf5eICAiJ. .'P<.-ul,(~/lJh
Plumber's Indiana State License #:
--PC /qt.tIOOG-4?4 .
J
# Charged Re-
Reviews
P,R.I.F.:
Additional Fees
,
C't'~,-' HI . -<;-0
Reviewed/Appro d: Dept. of Community Services (Date)
S:Permits/Forms/ILP RESIDENTIAL
Date