HomeMy WebLinkAbout06110060 Application
City of Carmel/Clay Township Permit #ObIIOO~D
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME 57EVE ~iC li1J//...'/)~/"'C PHONE
f54~ -(pG42
FAX
t/4.ZZ3/
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STATE
ZIP
STREET ADDRESS
( 0/6 312/) Mf: 5!-J. 5'JI~(()O
BUILDER'S EMAIL ADDRESS
P~Su5 7'iG'AOL.LilM
PROPERTY
OWNER:
NAME
PHONE
FAX
STREET ADDRESS
-'
SECTlON
/'
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ZONING:
12
,
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STATE
ZIP
LOCATION
&. PROJECT
INFO:
LOT # 41
ADDRESS OF CONSTRUCllON
'2- (p 2:2. FA.v~-r
/
a.
/
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/
\ 6/ :::l.S~
SQUARE
FOOTAGE:
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NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISS ON I BZA / BPW DOCK
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF AP CABL
~
/ /ESTIMATED COST OF CONSTRUcnON:
(EXCLUDING LAND VALUE) b'Sl9 190 D
SEWER lJT1LITY
PROVIDER:
OF IMPROVEMENT: PLUMBING CONTRACTOR: M 'tAI~{NGr
, *lS&eu Fe Ifr't> (jOO g?
e OO.Mmfl.'" fr?NSTAfJ~er's Indiana State License #:
O@ P~1il fNJ/:'lIfh ail r ON
i""ll!I~' c [O'"'/C egu'lltio
u,., ....to 0 lIS
C'T'cnFAfA.x. lU1~ de:Which plumbing codes will be applied to the construction:
o Dffi 6'E~ y S.E'~iI1l!s'ational Residential Code wI Indiana Amendments
6 ~~AcftWl~Ac TO'<iNtBHfP' Plumbing Code wI Indiana Amendments
MOLITI (Multi-Family Construction Code)
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc,)
PROJECT INFO~TION:
Early Release ,/ Manufactured
Permit: _y.JLN Trusses: _Y EN
~ 0 CRAWLSPACE
Lot Split: _YEN Sump Pump: ~Y NOS
Does any part of the property lie within a specia ood designation area: --'/2Y N
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o
:t8
POST & BEAM
BASEMENT
WALKOUT:_ Y ---1J-N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory strlc~ur)s, . .errnit is valid only if construction commences
within 180 days of the date of issuance of the building permit, and must be completed~tif at of Occupancy issued) within 18 months of the
issuance date. Class I structure permits 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 \vill 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 Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
~=::::::;...~Ot!(;?!:J~ J~PFrz.ey T. ~71/.~
Signa~~ Agent Print Date
P.R.I.F.:
**************
OFFICE USE ONLY: *********************************************
Filing Fees:
Base Inspections:
Cert. of Occupancy:
PECTIONS REQUIRED:
~~ Under Slab
" Mete se ~I ~
\J~/~
# Charged Re-
Reviews
Additional Fees
. (l
ReViewed/Approved: Dept. of Community Services (Date)
S:Permits/Forms/ILP RESIDENTIAL
Fee R
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