HomeMy WebLinkAbout07030085 Application
City of Carmel/Clay Township Permit#: 0703er:::J8f5'
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
r ,Additions, Remodels, & Accessory Stru'ctures
,
For Single Family, Town Home, & Two Family:
STREET ADDRESS:
Cj;;002 ;j
Df'v'/t:5
MERID/IlAi
New
I
'5tN9' 3531
CITY:
'XA/D {S
..3/fAX:f/ F' /'07/
STATE:
TA/
ZIP:
L/t..z?D
BUILDER
OF
RECORD:
NAME:
BUILDER'S EMAIl ADDRESS: b
+ err I H @ tOZ-E r. Co fY)
BEST METHOD OF CONTACT:
PROPERTY
OWNER:
E
r;:Fo~RE;)
~ DE:') 3/1
f{(IDIf/tJ Si-E 3DO
WOODS
D.e I V E
PHONE:
CITY:
L\.l Dfl.5
31
rJTE:
SECTION:
/
f/:;. 70 1-/
zr; 10,;2 fa 0
ZONllt 650 II /
LOCATION LOT #:, SUBDI~ SION NAME:
&PROJECT \ OtlCTOwN
INFO: ADDjESCf!JiqucnONU fA VI 57 A
SEWER UTILITY n A WATER UTILITY r' /\
PRDVIDER: L-f1 f tv1 E L PROVIDER: LJi I /III t7...
SQUARE
FOOTAGE:
(p &:> ()
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) 7, (JOb
R>l)T-r;~ 07b3c::ci~ pkL-,
t.
'" 1'<
TAX MAP PARCEL '#:
'II I'
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il.
;'j
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I ..--...., I
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
,
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR: ,
V SINGLE FAMILY I' NEW STRUCTURE ,0i1Z L ffl!.'Ii'i-~-S()-J.:5._~._.__J
'0 TOWN HOME RELEA ROOM ADDITION(S) Plumber's Indiana State license #:
o TWO FAMILY [Pc5Rilfil.<illll)U~CTION
# of units being Subject tQ:t~IJ~lIfI~~)regulat"on~ / 0.5 9 {) 9
constructed at this fth ..R MQQI;L.... oJ -
time: OlVtar 'alillkenleRt ftflQ~1i>nly Which plumbing codes w!" be applied to the construction:
o RESIDENTIAL (For DEPT Q6 OlO&!SliQlt'diQilt~~VICESO International Residential Code w/Indiana Amendments
Additions, Remodels,MY OF ~~_IItt~OWNSHif' Uniform Plumbing Code wI Indiana Amendments
PROJECT INFORMATION: 0 D' FOUNDATION TYPE: (Check all that apply for the new
Early Release Y ':;Z Manufactured construction area)
Permit: V ~ Trusses: V Y _N 0 CRAWLSPACE 0 POST & BEAM PIER
Lot Split: _Y N Sump Pump: VY_N 0 SLAB" BASEMENT(WALKOUT:_Y VN)
,
For Single Family and Two Family dwellings, additions. remodels, and/or accessory structures, this permit is valid only if construction commences within 180
days of the date of issuance of the building permit, 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.
1, the undersigned, agree that any construction, reconstruction, enlargement, 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 ~Zonjng Ordinance of Cannel Indiana -1993n (Z~
289) and amendments, adopted under authority of r.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
Occu cy has been issued by the Depart ent of Connnunity Services, Cannel, Indiana.
C..- ,-- IIA Mff-tlfr ,3f-01
Signature of Owner or Authorized Agent Print Date
OFFICEUSEONlY:*******************************************************~************************
INSPECTIONS REQUIRED: Filing Fees: ! 0 I -= d ()
(1Jpper F~g ~y{er Foo!fag Under Slab Base Inspections: -2 "!l ~~
" ') Cert. of Occupancy: .3. ,_0
~~ eAeter Ba~Cfjnal Si~ P,R.I.F,: IrA. G ( /~ 9 Additional Fees
!JJ1 _' ~ TOTAL: I __ (:t ;26 !.
Reviewed/Approved: Depl. of Community Services (Date) ~
S:PermltsjFormsjILP RESIDENTIAL
# Charged Re-
ReVIews