HomeMy WebLinkAbout07030169 Application
,. ,City of Carmel/Clay Township Permit #: n7tt> YJ//f1
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
NAME:
STRE:ET ADDRESS:
STATE:
I
ZIP:
'-IJ.6'
BEST MITHOD OF CONTACT:
PROPERTY
OWNER:
@ Q 1'1
PHONE: FAX:
CITY: STATE: ZIP:
IN I: IN
SECTION: ZONING:
L{ s-
SQUARE t,$?9
,,~ FOOTAGE:
WATER lJT1LfTY
PROVIDER: C
LOCATION
& PROJECT
INFO:
TAX MAP PARCEL #:
Early Release
Permit:
Lot Split:
y~
y=Z;
Manufactured
Trusses:
F PROVEME T: ireq. ,~UMBING CONTRACTOR:
fJ:,. to. .
U <..J()}- OF '. SMITH
R OM A D~~ 0 <S:;.J> eI'l. ~M1diana State License #:
ORCH DITION(~i<:- ~,... 'l~, , . '1h V')
DE DITION(S) ('.....0 ~'1 " ,
MODEL "')~.' <~"'.I. ,
. . h I '~ ~~I [.will be applied to the construction:
~ Basement FiniS on y " ....I"f/ n V \,fj
ACCESSORY BUILDING 41t^ '.II1te'~tl~~~~al Code w/Indiana Amendments
DETACHED GARAGE v~ l..i'. r:- .{>.!' . ~d;ft;;'A, .
AITACHED GARAGE ~unli9rn't'e.'>rb,"9 """b6"w/Ind,ana Amendments
DEMOLITION ~ /,;" I'"
FOUND : (Check all that apply for the new
construction )
o CRAW~E 0 POST & BEAM _5ER
o SLAB ~BASEMENT (WALKOUT:_Y~N )
I
--4_N
LY_N
o
o
o
PROJECT INFORMATION:
Sump Pump:
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is valid only if construction commences 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, 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 KZoning Ordinance of Carmel Indiana - 1993" (Z,
289) and amendments, adopted under authority of LC 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
Dc upancy has bee~ issued by the Departrn~nt of Community Services, Carmel, Indiana.
LDIl.\ A. B;ll.hStlN(;- HEh.Il;fJE
Print
'311'1 JOG,
Date
OFFICEUSEONLY:******************************~~********************17~i':*~*****************
INSPECTIONS RE~UIRED: Filing Fees:.. II" L ()
<:QPper FOO~ L wer Foortn Under Slab Base Inspections. d 17 ,0 # c~:~~::;s Re-
~ Cert. of Occupancy: S.J _ <)0
~oug~.n _ eterBase ~i:; P'RJ~F': .'. .' ." 6. () 'IA. r;7dibonalFees
Id( ( ~b/'~O.JA.~~:-/~ ~{ LV
Reviewed/Approved: Dept of Community Services (Date) "-{;:i:f'i'(.~~ ~
S:Permits/FormS/ILP RESIDENTIAL Fee Received by:'/ Date