HomeMy WebLinkAbout07030057 Application
City of Carmel/Clay TownShipfJ/CUl- ~ Permit #:r:03/fl~f'{i)~''!I/
."A,_,~~_
RESIDENTIAL IMPROVEMENT LOCATION PERMIT A:PJ.!L]eATION
For Single Family, Town Ho~t Tw Famil : New Structures, Additions, Remodels, & Accessory Structures
NAME: Shannon Hinshaw PHONE: FAX:
BUILDER
OF
RECORD:
STREET ADDRESS:
STATE:
ZIP:
PROPERTY FAX:
OWNER:
STATE: ZIP:
LOCATION ZONING:
& PROJECT
INFO:
SEWER UTILTIY f) II I /'V"\ .. J?
PROVIDER: U!f.}iJ I UL
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
\/If TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release X
Permit: Y N
Lot Split: Y f N
Efil!{W(L'hu
r;
TY i! P. OVEMENT: PLUMBING CONTRACTOR:
~'~~l8"~ ~ crrLf)Jj{L
C AaRO~~fu>%GMts},o Plu er's Indiana State License #:
~ It >t ~~S)'I\ISl; /o~OOD57
~( Lvi!,) 1Tv.
o Ii!:'! 111fi(,i:" ?sR/ -h?/ll"s ~~IUmbing codes will be applied to the construction:
- <:I)!,.~t.lo: '[);;;':70AI
o ACCES 811 tbM',.. S OS, )C'(/~~l!\national Residential Code w/Indiana Amendments
g ~~:~HE ~ y /; (:'lTv/B Uniform Plumbing Code w/Indiana Amendments
o DEMOLITION 0/11/1, '12
'v.S, UNDATION TYPE: (Check all that apply for the new
structio" area)
Manufactured
Trusses:
~Y_N
_VlN
o CRAWLSPACE
o POST &
BEAM _PIER
Sump Pump:
~
SLAB
o BASEMENT (WALKOUT:_Y_N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is valid only if construction corrunences within 180
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure pennits 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, enlargemenr, 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 Carmel 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
Occ 'Fancy has been iss e by the Department of Corrununity Services. Carmel. Indiana.
. ,J-;-H/JAJO^/ /-/.J..W/-I41A/ d-j-IJ ')
Sig ture 0 ner or ~uthoriz Age Print Date
OFFICE USE ONLY: *********************************************************************************
PECTIONS REQUIRED' _ Filing Fees: !/{i:3, So
Base Inspections: J.- 77, 5; 0
Cert of Occupancy: r6'3" ~o
521,OD
~/ dt J/S:A.\, ~6
# Charged Re-
Reviews
(Date)
Date
~
Additional Fees
ReViewed/Approved: Dept. of Community Services
S:Permits/FormS/llP RESIDENTIAL
Fee Received bv: