HomeMy WebLinkAbout07030088 Application
City of Carmel/Clay Township Permit #:(J?D30tJ8'8'
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory StrJctures
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BUILDER NAME: PHONE: FAX:
OF VlI/t Ar<-'::. C c...../"", A-'L r;3 ,,,L cE-'1-S, S '] "7 -99 0 'f S 7 7 - 9 75"9
RECORD: STREET ADDRESS: CITY: STATE: ZIP:
/2'-80 Fo~1.::J /J~ As.d.oG""L'io. ZA/ 4bCJ~g
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT: S 77-q '10,-/
w~ iud/,A-.....~ c:.u..:Tok..4.1l..rl!.""u",:;..c<>'<..-j)d~ - e /-?~JL.-~
PROPERTY NAME: PHONE: FAX:
OWNER: :::s A-ck../ '.......,....c..1 'tL lJA.w 4-L r S8j-/ 6'1 <f
STREET ADDRESS: CITY: STATE; ZIP:
II 8.s; 2- Tl..u../l.AIT L-A.A/e. CA..~ L IA./ 4fc,aJJ~
LOCATION lOT #: SUBDIVISION NAM~: SECTION: C -ZONING: R2-L~
& PROJECT 70 s70.w€ """leL .3
INFO: ADDRESS OF CONSTRUCTION: SQUARE
IlesZ. TA~,",,,,r LA,..,.ti. <:4-~ l- Ll-' 41oo~ ~ FOOTAGE: ~C>
SEWER UTILITY WATER UTILITY c-,1: T ESTIMATED COST OF CONSTRUcrrON: . .
PROVIDER: C-t'T'" PROVIDER: (EXCLUDING LAND VALUE) .', ,? 1. So e ,0. Q
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / ;rw DOCKET , rMti I j LUU/
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
--.. .---- +.-.- ,
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL #:
FOR THIS PROPERTY:
U.M --- - _..~_.._-
TYPE OF IMPROVEMENT~ PLUMBING CONTRA~OR:
&~~M:~:Ei~~ Y1 P=r'::~~; s~,;;~-r:':"'';~IIG.~
a~ nc~';r~ON(s)sfe 8/077"7/
\., ~EMODEL t Finish O~yY' Which plumbing codes will be applied to the construction:
o ACCESSORY BUILDING 0 International Residential Code w/Indiana Amendments
o DETACHED GARAGE ~ . . .
o ATTACHED GARAGE L=.J umform PlumbIng Code w/Indlana Amendments
PROJECT INFORMATION: 0 DEMOLITION / FOUNDATION TYPE: (Check all that apply for the new
Early Release L/ ~nufactured /"1) construction area)
Permit: Y _~ /russes: _Y -c:! 0 CRAWLSPACE 0 POST & BEAM ~PIER
Lot Split: _Y -W Sump Pump: _Y _N ~B 0 BASEMENT (WALKOUT:_Y_N )
TYPE OF CONSTRUCTION:
~INGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is valid only if construction co
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy issued) within 18 mont f . ass I
structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regard~'n . ~ _ fr ing and
completing construction. ~
I, the undersigned, agree that any construction, reconsrru~ment, relocation, or alteration of a ~ e, . . t e use of land or structures
requested by this application will comply with, and-;onfonn to, all applicabl~l~s of the State of Indiana, i rdinance of Carmel Indiana -1993" (Z'
289) and amendments, adopted under authoJicY of I.C 36'7 et seq, General Assembly of the State of Indiana, all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connect to the sanitary sewer. I further cert\fy that the construction will not be used or occupied until a Certificate of
Occupancy has been issued by the De tment of unity ervices, Carm I, Indiana.
V
~ . Sn v6. VI/itA.....";,., 3//3/:u.,,7
Signature of Owner or Authorized Agen ~ Print Date '
OFFICE USE ONLY: ****** ***** v * **** ******************************'b~***)j-'******************
INSPECTIONS REQUIRED:~.J.k Filing Fees: / ' ~ ~~
....c.:' . riii2. . -,..- '\ Base Inspections: / h (,. .) {/
~per Fo~g. Lower Footmg abJ '/ :)'{}
- - ~ Cert, of Occupancy: 4 J .
Qough In-=::> Meter Base Final Site ./)
___ P.R.LF.:
# Charged Re-
Reviews
, 3~
Dept. of Community Services
S:F'ermitsjformS/IlP RESIDENTIAL
~07
(Date)
Additional Fees