HomeMy WebLinkAbout07040049 Application
City of Carmel/Clay Township Permit #: 07D# ~D4cr
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
NAME:
PHONE'581-/1Jvf3
STATE:
J1V
FAX:
'7 500~4545
PROPERTY FAX:
OWNER:
LOCATION
&. PROJECT
INFO:
STATE: ZIP:
ZONING:
SQUARE r
FOOTAGE: &&/::> /
ESTIMATED COST OF CONSTRumON: 1 r 2;:::" /1/'111
(EXCLUDING LAND VALUE) -P J ~ VlA./
lZt''&he ( J '# 070
SEWER lJT1lITY
PROVIDER: j)
NAME OF lJTlLITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATEeS); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
TYPE OF CONSTRUCTION:
r2f' 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: Y ./' N
Lot Split: Y /N
e~
TYPE OF IMPROVEMENT:
[3"""'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 DEMOUTION
Manufactured
Trusses:
Sump Pump:
y~
~N
TAX MAP PARCEL #:
PLUMBING CONTRACTOR:
( , J /)
P;V I diR:iq560~ 00
Which plumbing codes will be applied to the construction:
o International Residential Code w/Indiana Amendments
~iform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area) ~~
o CRAWLSPA~ 0 PO ~~ _PIER
o SLAB [!j""BASEM ~~_y~
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is v ction conunences wit~ 180
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy issue onths of the issuance date. qIass I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lACe. ar e piration time frames for beginning and
completing construction.
t, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a stru . e, 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 - 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
ace pan h~beeni,,~e bYthLl7J1ov1YrUnitYSemC~c~;;;;rt ~i20tJ{) +/7/01
Sig '0 Authorized Agent Print Date
OFFICEUSEI~~~~;*******::;~:~:::*************~~~;;:::;************~{?*~*~~*****************
B I ct Ons' --, €I 7. # Charged Re-
U F t. L F t' U d SI b ase nspe I. .-L r7 .
pper 00 mg ower 00 ,ng n er a ReViews
5S'SO
1,1 CI () 0
# ,..;:;6S3,/0
Wlol () 7
Date
Rough In
P,R.I.F.:
Cert, of Occupancy:
Additional Fees
Final
-s.fe
)
ReviewedjA proved: Dept. of Community Services
S:Permlts/FOfmsjILP RESIDENTIAL
M TOTAL:
VYY) ~
Fee Received by: