HomeMy WebLinkAbout07030119 Application
City of Carmel! Clay Township Permit #: 07030119
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:
SEWER lfTILITY
PROVIDER: (t1fl ilD
If)
Orrl-l
(!.c:t.rme../
FAX: 'ltJ(c-O:XJ,),
:JjJE: '-1-00.3 rJ
tHi~rM";;D:eOt~: 5tqO.-4&t.f~ (C)
FAX:
tJiJ-060:J,
STATE: ZIP:
:RlJ LftJ03';!
PUD
SQUARE
FOOTAGE: 10 .
EST1MATED COST OF CONSTRUCTION: 1/1/7 0/1/1
(EXCLUDING LAND VALUE) U~. vV
~("i. :i~u'J3U1{
3/1
567- ,
PHONE:
r'}VfrO':58J 7
erv;;e:.
qb08a
NAME OF lITlLITY EXCAVATION CONTRACTOR; PLAN COMMIS ON / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
lZ/ '5he//
(J1 o'!J 0 \ \ 1? TAX MAP PARCEL #:
FLOOD ZONE AREA DESIGNA ON(S)
FOR THIS PROPERTY:
TYPE OF CONSTRU ON:
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc,)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
-y~
-y~
)( - ~V'/.sh o..cJeA
TYPE OF IMPROVEMENT:
c7 NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDITION{S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmDN
Manufactured
Trusses:
Sump Pump:
y -<:
X=N
~RACTOR: _'
I ,'I) -=J our I((joe~
Plumber's Indiana State License #:
Pf~ I QS 00000
Which plumbing codes will be applied to the construction:
o International Residential Code w/Indiana Amendments
0" Uniform Plumbing Code W/In~~~ Amendments
FOUNDATION TYPE~~~~ apply for the new
construct io..n.are.all..'~ . ~ ~'
~",Or:.~~ .,.,&,.
Of)~~~~ ;\.!i~';- BEAM_PIER
. S~iJf,lUlft . ~ ._y~)
For Single Family and Two Family dwellings, additions, remodels, andlor acces _ f:\l~ '~.. . ~ ' . .. construction conunences within 180
days of the date of issuance of the building permit, and must be completed (Cer . ., . ~u ~j\i..~ 1i~' 'months of the issuance date. Class I
structure permits are subject to the General Administrative Rules of the State of I iana (See ~ 1:~L\l~~i. , ration time frames for beginning and
completingconstru~~l\. oJ r,~'(\"'''''' .....'\\)..,,;, \ .
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, di)1!f2r.~nr'structu>>1r any change in the use of land or structures
requested by this application will comply with, and confonn to, all applicable laws of the. I~rt'i;na, and the' "Zoning Ordinance of Cannel Indiana - 1993" (Z~
289) and amendments, adopted under authority of I.c. 36~7 et seq, General Assembly of tIi te of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, b , and fl r drain are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
DcG cyhas be 'ssue y e a<t nt 01 Conununity S,tvices, Carmel, Indiana. /).J r1
! ~ u';;lrlle !!2!fluJ() 3!h/o1
Print Date
OFFICE USE ONt Y: ******************************************************
Filing Fees:
Base Inspections:
Cert. of Occupancy:
INSPECTIONS REQUIRED:
~~~~~underSlab
~e~er;;~c,";'- ~
f
P,R.I.F,:
# Charged Re-
Reviews
Additional Fees
3~1,3-o7
d: Dept. of Community Services (Date)
S:PermitsjFormsjIlP RESIDENTIAL