HomeMy WebLinkAbout07020169 Application
City of Carmel/Clay Township Permit #: D'lf)::l,O/tJ9
'j RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
PHON~:I r--
f:?-/J'io
~~" ~
ZIP:
sfG..;;l9
BEST METHOD OF CONTACT:
STREET ADDRESS:
S---\t..... <;,.t
. fiG, (0""
PHONE:
Xq"----/ g7r
sj- lIArs
e 0:
FAX:
8 t/ 2.. -p?-(,?
/::ATE
SECTION:
LOT #:
ADDRESS OF CONSTRUCTION:
/</3 'Tn.),
SQUARE
FOOTAGE:
n
w
SEWER UTIUTY WATER UTIUTY
PROVIDER: G-(d2 wi) PROVIDER: (ifo.Y~
NAME OF UTILIlY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT "5 (IF APPllCABLE):
ESTIMATED COST OF CONSTRumON:
(EXCLUDING LAND VALUE) ';)'/,)/ () 00
J /}-If
r;\(CQUCc!' C '* tJ102dtB
TAX MAP PARCEL #:
-
. ~kl4teA..
",/ l' \\..--:.' ,\ '"''
TYPE OF CONSTRUCT1oN::::; <\'::~iTYPE'Q~~PROVEMENT:
~ .....':: \j......... '\ \\
;B SINGLE FAMIJ y. tfC, \~/"j N .., 5if1t,UCTURE
o TOWN H.OME~::., "-of/ .,' ROOM,AD'ilITION(S)
o TWO FAMILY, -v;;/ .. '\. PORGH'AODITION(S)
# ofu'~i,,"\~~ng . n',." O.O_ECKAOO.IrION(S)
c.onst"!.cted at th,!!(t.u 9/REMOp~L/'. .
time: '.\.........\..\, ",./'" ~.Basement Finish only
o RESIDENTl~~,(F"or. /- O;-ACCESSORY BUILDING
Additions. Remodels,.Etc,) .........0 DETACHED GARAGE
\{" /" 0 ATTACHED GARAGE
\. '/
PROJECT INFORMATION: 0 DEMOLITION
-
PLUMBING CONTRACTOR:. .
~/ wdl (ne-c. P'V(fl7blr1;;~:D>td(~Willltu1\S
'/ Plumber's Indiana State License # I L
r: '~~'..P 7 'PC I D3 OD?-7 +-
Which plumbing codes will be applied to the construction:
-grntemational Residential Code w/Indiana Amendments
o Uniform Plumbing Code w/lndia~~dments
\ \c..~o~'b
FOUNDATION TYPE: (~~Ii!?,a,';;apPIY for the new
construction area) ...0":' 0\\ \"., ",-CO
<'. v :{(\ ~ _",0'1>' \CJ~.,\?
o .",CfjrJ!CS.~~ '1' c~0~~~~ ~wr _PIER
<;;'~S'~(\~(B.,g~~( '''I.""r:: Y~N)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory struc ~~Ps ~ il'~~bWY if s~ti~~~ommences within 180
days of the date of issuance of the building pennit, and must be completed (Certificate ofnccup~2 issVedr~)s nt~~~ the issuance date. Class I
structure pennits are subject to the General Adntinistrative Rules of the St.ate of Indian~ (See 67>,?~ 12j ~h~~\.ti'(;n time frames for beginning and
completmg construction. '0"" ()~ -,
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteratiqJ.1~tl'Gcture, 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 In1!4A'h1, ~nd the "Zoning Ordinance of Carmel Indiana - 1993" (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 ate connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Cerrificate of
oeeu~""ey has been i5'ued hy the Department of Community Servie"" Carmel, Indiana. .
s;.n.tu'~~ p';ntC\V\'\,~..c<:skor /::,!;r,}ol
Early Release
Permit:
Lot Split:
_yj(N
_VAN
Manufactured
Trusses:
~Y_N
')( Y _N
Sump Pump:
# Charged Re-
ReViews
Si~
Cert. of Occupancy:
P,R.I.F.:
Additional Fees
3.~-c>
Dept. of Community Services (Date) .
S:Permits/formsjILP RESIDENTIAL