HomeMy WebLinkAbout07030113 Application
'c::::;:~&'*5 City of Carmel/Clay Township Permit #:D~ 030113
. )"';',RESIDENTJAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, 8< Two Family: New Structures, Additions, Remodels, 8< Accessory Structures
1 NAME:
1--
BUILDER
OF
RECORD:
. STREET ADDRESS:
/4
BUILDER'S EMAIL ADDRESS:
PHONE:
FAX:
CITY:
r/VOPLS.
STATE:
ZIP:
BEST METHOD OF CONTACT:
PROPERTY
OWNER:
NAME: lk~\.. enl<..\ fI-;:.I''tDr< I PHONE:
.f ur""skq "" fri' Df( 7levGuhlc U Ii> '~nI$t'
FAX:
STREET ADDRESS:
. '-f (pf' I 13'.... ~rWml T C1lL(:.
LOCATION
8< PROJECT
INFO,
LOT #: SUBDIVISION NAME:
.... /'2-'3 1$(.,;"'3 FDs*" bo.;{
ADDRESS OF CONSTRUCTION:
4f.,~( \3n...~ 'Th<<<
SEWER lJTIUTY
PROVIDER: CClI'l"'>{1
WATER UTILITY
PROVIOER: Ctt~<\
NAME OF LfT1LITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE):
TYPE OF CONSTR
o
o
o
f1J.
PROJECT INFORMATION:
Early Release
Permit:
Manufactured
Trusses: _Y 4-N
Sump Pump: _Y X-N
Lot Split:
_Y 1L,N
_Y~N
CITY:
STATE:
ZIP: Lf 1c:033
UtfM<i
IN
SECTION:
ZONING:
ESTIMATEO COST OF CONSTRUCT/ClN: '/(.
(EXCLUDING LAND VALUE)r/ I" '" / - <'.( ,
[if'
/.'1 (/1
//1 .11/
I,.! 1/: b
C'! IYh
! {
TAX MAP PARGEL #: -.....
~
PLUMBING CONTRACTOR: ~-'''- -~, JILl
CufP pLum (3/1\1&"-" '. ~/
Plumber's Indiana State Lic;-~~1 #; ~,J
ehC-P / f) 7 1.dt2!J./ Z-
Which plumbing codes will be applied to the construction:
" .
, '
.......
6 ?oo;
o International Residential Code w!Indiana Amendments
(KJ Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area) (/!'K,f 5 71/1/ (;. )
o CRAWLSPACE 0 POST & _ BEAM _PIER
o SLAB 0 BASEMENT (WALKOUT:_ Y _N )
For Single Family and Two Family dwellings, additions, remodels, anellor accessory structures, this pennit is valid only if con~truction commences within ISO
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 "Zoning Ordinance of Carmel Indiana ~ 1993~ (Z~
289) and amendments, adopted under authority of I.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
o;p~"ued by the Dep"t~~~~Unity ~c: c~; [,J. ,4~;'tO~ ~ 31 wf07
Signatureo~owne@UthOrizedAgent I '0. LiS/ )Print Date
\ v /'
OFFICE USE ONLY: * * * * ** * * * * * ~* * * * ~*** * ** * * * * ~~ * * ** * * * * * * * * * * * * * * * *,., * *!J. * * ~ ** * * * * * * * ** * * * * * * *
INSPECTIONS REQUIRED: FIling Fees: ~/./... .-1J
. . Base Inspections: / / (. (/0
Upper Footing Lower Footing Under Slab ~ -(j
~ ~ ~ Cert, of Occupancy: -.J3 -->
Rough In Meter Base ~I Site .
_ _ P,R.I.F.:
'3-a&
(Date)
TOTAL:
~~'?
Fee Received by:
',381 Lj(jj
L/-1\~(~'1
Date
Dept. of Community Services
S:Permits/FormsjILP RESIDENTIAL
# Charged Re-
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Additional Fees