HomeMy WebLinkAbout07040037 Application
SEWER UTIlITl ,/ i C/ .
PROVIDER: 5.>-,'i-...<"G /J-v;'
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
City of Carmel/Clay Township Permit #: tYltJJ./tJtJ31
RESIDENT~ IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
NAME:
(411(
PHONE: 7b.5- 7?~ z:.7:f;8
FAX:
Q
STATE:
r:-,..
ZIP:
cm: ?
1 :R..e.tcl/.dOvl
STREET ADDRESS:
7.-731 ;;'A-./.a"
BUILDER'S EMAIL ADDRESS:
(!j,
BEST METHOD OF CONTACT:
NAME:
SECTION:
ZONING:
FAX:
PHONE:
317
~!i-fl( -'--
704 '190-4
STATE:
;c.
STREET ADDRESS:
97bz
cm:
ZIP:
0li3z
t--!
1/1 h7e L
LOT#:
SUBDIVISION NAME:
o ,
/0
SQUARE
FDCTAGE:
/44
e
ADDRESS OF CONSTRUCTION:
COST OF CONSTRUOlON:
D VALUE) f Z
WATER UTILITY
PROVIDER:
NAME OF UTILm EXCAVATIDN CONTRACTOR; PLAN CDMMISSION / BZA / B
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT #'S (IF APPL
<"~- I.
FLOOD ZONE AREA DESIGNATION(S)....-,..<'_."?~: '~\\\~\
FOR THIS PROPERTY: ...---.~ 'y. f! \;;~ \' \ \
.----:~ ,,11 .__/~ \
TYPE OF CONST.wffiON;~- p' F' 8
g ~~lt7' - " 1Il'1i 'l :,::;",."... ~"_. ~."~ _ "m'::~,
o TWO FA~I t...'?~ RCH DOmON(S)$aeenet.'
# of'~ I einll" DECIY' mON(S) /lxl z..
consb- at this REMODEL
time: \ \ \ \ \ Basement Finish 0 Which plumbing codes will be applied to the construction:
o RESIDENtIAL (~or ACCESSORY BUILDIN~,.
Additions.' emode DETACHED GARAGE '
ATTACHED GARAGE
DEMOLmON
_Y /N
_Y~
Manufactured
~ Trusses:
~ump Pump:
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_Y --A-N
_Y/N
o
o
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit 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 18 months of the issuance date. Class I
structure pencits 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 - 1993n (Z~
289) and amendments, adopted under authority of I.c. 3G:J.eueq,.General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify thar only
kitchen, bath, and floor drains are connected t sanitary sewer. i1Urth~rtify that the construction will not be used or occupied until a Certificate of
Occupanc.rhas been issued by the Dep ent of Community Servi<;es, C el, Indiana.
OFFICE USE ONLY: * * *** * * ** * * * * * * ** *** * * ** * * * * ** ~ ~* * * * ** * **** * * ** * *** **/: * 5:'*",,*** * ** * * * * *** ** * *** * * *
SPECTIONS REQUIRED: FIling Fees: ,~ ' 7 j7
, . . Base Inspections: / / s: rJ 0
per Footln Lower Footing Under Slab . (" 0
~ .~ Cert. of Occupancy: .<7 s= .5
Rough In Meter Base ,-Final Site
W J1 ~ - P.R.~ / TOTAL: Iff 3,;2,_;;;onal Fees
Reviewed/Approved: Dept. of Community Services (Date) ~;f;t['-4-2J C~~
S:PermltsjFormS/ILP RESIDENTIAL
~
4-(" - 07
Date
# Charged Re-
ReViews
Fee ReceIved by:
Date