HomeMy WebLinkAbout07040024 Application
City of Carmel! Clay Township
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
permit#:~
For Single Family, Town Home, 8r. Two Family: New Structures, Additions, Remodels, 8r. Accessory Structures
BUILDER
OF
RECORD:
NAME:
PHONE:
75-;)350)( d{)b
CITY~EL
FAX:
mES
.Dt AJ S-T
BUILDER'S EMAIL ADDRESS:
DAIJ N{;.. . S H6Prlt:ell Q Pu-cn- ,~0YY\
s'Pvllb
>r71J
ZIP:
I.jJo () 3:J-
BEST METHOD OF CONTACT:
-e.
AIL-
PROPERTY
OWNER:
NAME:
PHONE:
FAX:
STREET ADDRESS:
CITY:
STATE:
ZIP:
LOCATION
8r. PROJECT
INFO:
LOT #:
].J8
SECTION:
ZON~:_l
SEWER UTILITY
PROVIDER:
ADDRESS OF CONSTRUCTION:
I'-\-Og~
~5L
SQUARE 5 rI OL. --
FOOTAGE: ,OJ
5
A-l SuPc0 az c c-'
TAX MAP PARCEL #: 00 c: CO
11-10-2.2- - O~:/L' 0
PLUMBING CONTRACTOR:
UCT E ~-rAmW\ -t.-.sDAlS I INc...
ROO DDITI (S) bl!!umber's Indiana State License #:
P CH AD ON(S) '7l::l.mcO., J fY\ I
ECKA ITION(S) SUb' ~n:.DO I 0
RE~B6El .. h I ,k~Fci./plumbing ~"'iJlbe applied to the construction:
/' Basement FIniS on " """'~.r8f _'vrnp/ '-.'UIII<:o
ACCESSORY BUILDINC ,Or.:-pr. i1t&n!l!;loHilr~elltiat.c;Q<k:.w/Indiana Amendments
DETACHED GARAGE 01'i'y'",,' f:.(;;,' QI7(j,. It~'{J/I~~U{.71l;;)~ I
ATTACHED GARAGE fJ!: f:.nl Qi\li!ll"0}'b~t"o-:WIj>m!).ka. ",",endments .
DEMOlITION ;<{,q A_ (JI In. deS liOns
FOUND'A 0 PI[: ~i:k ail that appiy for the new
Manufactured ~ constnl~B}A' Y "'0 IIICI2S
Trusses: _Y _N 0 CRA~PACE ~!,l'tF:~~..tttfIER
Sump Pump: --V _N 0 SLAB rn--BAsEMJ;.;rrvrlLKoiJf:_~~Jfl1
QJ)u.RT
WATER UTIlITY
PROVIDER; CA~a
ESTIMATED CO>r OF CON>rRU
(EXCLUDING LAND VALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR CDUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTI . ~
I91INGLE FAMI.!-Y~A _
o TOWN HOMEr ~ 'qu
o TWO FAMiL y\~ ~ .-
# of unitS ~e!~g\ ~
constructed,"at/this,
time: \\\ ~
o RESIDENTIAL (Fot~ '\)
Additions. Remodels) Etc.)
PROJECT INFORMATIO .
Early Release /'
Permit: _Y ~N
Lot Split: _Y ~
For Single Family and Two Family dwellings, additions, remodels, andlor accessory structures, this pennit is valid only if construction commences within 180
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within IS 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 "Zoning Ordinance of Cannel Indiana -1993" (Z~
289) and amendments, adopted under authority of r.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
Occupancyhas been i d by the Departm nt of Community Services, Carmel, Indiana.
0DAtJ tJE ~~EPrt8W !d-/ 4/ ()7
f Owner or Authorized gent Print Date
Slab
# Charged Re-
ReViews
Final Site
P,R,I.F,:
(Date)
S:Permits/Forms,fILP RESIDENTIAL