HomeMy WebLinkAbout07030221 Application
City of Carmel/Clay Township Permit #: 07D30~'1
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
NAMEPU..LT6
PHONE: FAX:
5 75 .;L3SD X d-O~
CITYCA-/2J--i EL STA/: A.J
ZIP'tj 0032-J
STREET ADDRESS:
BEST METHOD OF CONTACT:
. QDm -GfYJAtU
PROPERTY
OWNER:
NAME:
PLLLTE
PHONE:
FAX:
STREET ADDRESS:
rtGmES
0.fttl1b
CITY:
STATE:
ZIP:
LOCATION
&. PROJECT
INFO:
LOT #:
;;JIlt>
LoSN
ZONING:S -1
SQUARE t:::i 'q 0
FOOTAGE: -.JC-f
/ I q J-q 3
iUOtL. E'iC-.
'a MAP PARCEL #:
<S-ID -ll-oO-)rJ -003. (JO
TYPE OF I 'E: P RACTOR:
if NEW m~ URE VI Cj....~.
o ROOM AD S~, ____Plumber'S Indiana State License #:
g ~~~~~~g~ON(~ C Pi DODD I 0 \
o REMOD~F' . h Which plumbing codes will be applied to the construction:
Basement InIS '
o ACCESSORY BUILDI' ~temational Residential Code w/Indiana Amendments
o DETACHED GARAGE .. .
o ATTACHED GARAGE J Un.form Plumbing Code w/Ind,ana Amendments
o DEMOLITION
,,-
TYPE OF CONSTRUCTION:
r/ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions, Remodels. Etc.)
!l
PROJECT INFORMATION:
Early Release /'
Permit: Y N
Lot Split: Y ~
Manufactured
Trusses:
Sump Pump:
v: N
~N
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST &_ BEAYl PiER
I J II.lI-TII101~-'
o SLAB GVliASEMENl"(WA[KOll1':~Y~)
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 aZoning Ordinance of Cannel Indiana - 1993~ (Z~
289) and amendments, adopted under authority of l.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
Occupancy has been i. u d by the Departme of Community Services, Carmel,Indiana.
~ "-.J.DA-AJ /J 6 ..st+E11-tlfLJ
I Signa f Owner or Authoriz Agent Print
0J~o'l
Date
\
OfFtC U5EONlY:***********************************************************l*********************
F'I' F . q 37 ()O
PECTlO UIRED: ling ees. . /
.-.---. Base Inspections: /-:J? I .)j
er Slab
~- 3 SO
1v2 &! (JC
;.f/,.JS30 Or)
# Charged Re-
Reviews
Cert. of Occupancy:
Final
Si
P.R.I.F.:
Additional Fees
TOTAL:
Reviewed/Approved: Dept. of Community Services (Date)
S:Permits/forms!ILP RESIDENTIAL
Fee Received by:
Date