HomeMy WebLinkAbout07040092 Application
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City of Carmel/Clay Township Permit #: 07 D'-liD09J.t
I
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
NAME: t,
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FAX:
12
PROPERTY
OWNER:
STREET ADDRESS:
lP\.glolo \::...'
CITY:
BEST METHOD OF CONTACT:
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PHONE: FAX:
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STATE:
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ZIP:
L/(pdSO
CITY:
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STATE:
ZIP:
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LOCATION
& PROJECT
INFO:
LOT #:
SUBDIVISION NAME:
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SECTION:
ZONING:
~gg~E: Gtocr9
SEWER UTILITY WATER UTILITY n
PROVIDER: C \~ \:) PROVIDER: L.. CI\ v-~(.. \
NAME OF UTILITY EXCAVATION CONTRACTOR;'PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUN1YYi~,L'A.ND/OR SEPTIC PERMIT ,'5 (IF APPUCABLE):
..,.' .'-. '-, ~ "\, \
FLOOD ZONE AREA DESIGNATjON(S)\ \~';\.\ \~
FORTHISPROPER1Y: /;;'\~~y \\\ \~
/.V'" ~/ \" \\
TYPE F CON u" .. ON: ~ TY..' PROVEMENT: PLUMBING CONTRACTOR:
SIf:l~lf~~)rf/ 'l- 1)>~ "'''~t -'i\'\". (' n....\-rcJ\J;..r<:.
o TOlNN'J;lP,ME \ Q)?ITIONt$)c.; C"" , Plumber's Indiana State license #:
o TWOfA~Y ~~ 0 "9 tI(ADDmo.!l~) '-.'\:STR{~
#'O!,u~t;S-.bein~ D.Pf2.Ej;,KA(jDm~!\I(S 'ICe WII,'] au '-~'UJ.\IlLl ':540
consttu~'datthis Q'"'RE<Mi5QE~""~' cJ 10 . I(JOul;m__"'
time'h\ \ \"2\ ., / f..i/iv raa~e~~;Flrir~1 ~i1\~~ CC~Jdi ~tOdes w.i11 be ~PPlied to the construction:
o RESIDENT,I~l (For ,/ 6' AcCESSORY ~\l.~l-9IN~ 'II V s~n.iatl~nal ReSidential Code w/Indiana Amendments
Additions. R~models.J 0 DETACHED G~gf Cl ~ '.,,, C/'IVIi j::'c:dl
o ATTACHEDG .. . .. 'I 18t1Jt~ iiI'hl'p!umbing Codew/Indiana Amendments
o DEMOLmON I'VvA HIP
PROJECT INFORMATION: FOUNDATION TYPE: (Check all that apply for the.new
Early Release Y /N TMruansufseas~. ured /./ ':Y_N construction area)
Permit: ~N 0 CRAWLSPACE 0 POST & BEAM PIER
lot Split: y LN Sump Pump: Y _N 0 SLAB q BASEMENT (WAlKOUT:_ Y ~N )
ESTIMATED COST OF CONSTRUCI10N: C") 00 .......Q,c,
(EXCLUDING LAND VALUE) .:::>. '-'
w'\\s~""
TAX MAP PARCEL #:
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences witJUn 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. <;:lass 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.
!, 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 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 as been i by epartment of Commnmty Semce', Carmel\ndim.
-.Jn~_\'-\,^ ZIlHt-v:> 1 Ac..~^"--t ~-\d.-D{
Print \..J U Date
OFFICEUSEONLY:******************************~~******~**************'~*~***********************
INSPECTIONS REQUIRED: FIling Fees. LJ , ~ . 7"0
Upper Footi 9 cfo"wer Fo~t~ Under Slab Base Inspections: ~ J 7. ~ tJ
--."..---:: <... Cert. of Occupancy: S<; )"0
Meter Base-<-......!inal -sit~ . ()() ,
LJ~ W4 P.R.I.F.: ~7lfr;td6'1;d;/Fees
Reviewed/Approved: Dept. of Community Services (Dale) ~ -
# Charged Re-
Reviews
~,
S:Permits/Forms/ILP RESIDENTIAL
Date
Fee Received by: