HomeMy WebLinkAbout07010178 Application
'21
SEWER UTILITY WATER UTIUTY ESTIMATED COST OF CONSTRUmON: "i-
PROVIDER: C4/2t"t(? L- PROVIDER: eJ\~a (EXCLUDING lAND VALUE) 7' /7--0, 000
NAME OF UTILITY EXCAVATION CONTRACTOR; PL'.N COMMISSION / BZA / BPW DOCKET j.)1LA.-S e'(.C4 VA:'rl.u~ r~ b f4...~ Docjt-€"'r
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE): ..lbi.-S :b V 0 o~3"" 0 .1e> ,>'"2-
FLOOD ZONE AREA DESIGNATION(S) . ~ if ," TAX MAP PARCEL #: "-D<j-'2.';--O-z.-O=:~OW,D 0
FORTHISPROPER1Y: '2o~t;;;,Ie 070/01'3 '''-llI't_~-o?z-~j-o~I.'' 0
TYPE OF CONSTRUCTION; TYPE OF IMPROVEMENT: '* 17 05' PLUMBING CONTRACTOR:
o SINGLE FAMILY !ii NEW STRUCTURE 121 ~ Pw ,"'t Si ~(j
~TOWN HOME 0 ROOM ADDITION(S) Plumber's Indiana State License #:
a TWO FAMILY 0 PORCH ADDmON(S) ,.--
# of units being 0 DECKADDmON(S) c.fS?&"6' b I> I~ 7)
constructed at this 0 REMODEL
time: _ Basement Finish only
o RESIDENTIAL (For 0 ACCESSORY BUILDING
Additions, Remodels. Etc.) 0 DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
~
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
So PROJECT
INFO:
City of Carmell Clay Township Permit #: () 701 0 17 ~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, So Two Family: New Structures, Additions, Remodels, So Accessory Structures
NAME: PHONE:
&zj)(f3 ttv,JYr/lA &v1t.-/),;-yl-"5, '[:NC.. 31"l-9is;-'1~...,r
FAX:
3h-SQS--2-/bf
STREET ADDRESS:
J'7;'B; cj2Alq ~. 1l:/vo
CTIY:
:r Ai t> i4.. A PH-/:
STATE:
T..:>
ZIP:
4b 2.<;;"0
BUILDER'S EMAIL ADDRESS:
~M05htv-e "s-lv-tbv:{ciev '. COM.
BEST METHOD OF CONTACT:
f:{ut!- t4.-sh.4- ell
,0.1- - ~"3'2-
NAME:
PHONE:
s11- .,qr-9o&(f
FAX:
3i7- S-qs-- 2-/6(
MorJD..J {' MIl(,.j uc.
STREET ADDRESS:
,f'3~5
LOT#: (gA
CITY:
J::;.>l)i" uAI'", I..t S
SECTION:
;'n-.. on. _"
,...,....J,<~...,
STATE:
ZIP:
L{- 6 'l S7>
tt:{DD
C a.4 l.c <;-:r:
,...J
ZONING: P lJ 1
SQUARE _ ~"l :5 f-!
FOOTAGE: ~.."
SUBDIVISION NAME: ~
l1otJ'i>f-J ~.
M4',,",
ADDRESS OF CONSTRUCTION:
-t-t. 2.:3 2..
<.~
i..-NJe'
eMMa..
::C,J
Which plumbing codes will be applied to the construction:
~Intemational Residential Code w/lndiana Amendments
o Uniform Plumbing Code wi Indiana Amendments
_VXN
_Vl(N
Manufactured
Trusses:
Sump Pump:
FOUNDATION TYPE: (Check all that apply for the new
construction area)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
KV_N
_VX-N
o CRAWLSPACE
o POST&
BEAM _PIER
~ SLAB
o BASEMENT (WALKOUT:_Y~N)
For Single Family and Two Family dwellings, additions, remodels, accessory structures, this pennit is valid only if construction commences within 180
days of the date of issuance of the building pennit d (Certificate of Occupancy issued) within 18 months of the issuance date. dass I
structure pennirs are subject to ~ e .e of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
G.' mp eting construction.
I, the undersigned, agree th s .ruc~io?,"enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this application comply with, and conform to, all applicable laws of the State of Indiana, and 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 oor drains are connected to th anitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupancy as n' ued y the Dep tmen f Community Services, Cannel. Indiana.
<toT( I\t. MPS ~
Print
.ate I!ZC!DI
OFFICEUSEONLY:*********************************************************************************
F.t. F . //~ 60
INSPECTIONS REQUIRED: I Ing ees. to ' . -
F ---"'t'. F t" ~ - Base Inspections: ;;; '7? -(()
per ootingLower oOlng
.?3' :i()
# Charged Re-
ReViews
Cert. of Occupancy:
I
Rev1ewedjApp Dept. of Community Services
S:PermitsfFormsfILP RESIDENTIAL
Site
::NlIF:
Additional Fees
Fee Received by:
Date