HomeMy WebLinkAbout07030222 Application
~
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER UTIlITY
PROVIDER:
City of Carmell Clay Township Permit #: 07 D 3() 'Jj~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
NAME:
PHONE:
-,7''1',,:1
CITY:
'~j ,It-
FAX:
v.'
ro'
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STATE:
STREET ADDRESS:
(" ( ,,, ,/
BUILDER'S EMAIL ADDRESS:
v _ ~ ,-0- e.U"l~
BEST METHOD OF CONTACT:
NAME:
coli
317 S Pi 13> 0
STATE:
IN
Z6~ 3 ~
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FAX:
c
Ii j"lt-<--"","'-
STREET ADDRESS:
I). 65 Li VV\ ~y loS'1
"bt:Ut<
CTIY:
CC<..X "'~
LOT#:
30
SUBDIVISION NAME:
\~0ohC\.Wk c(o 55;'"
SECTION:
ZONING: . /
5:-
ADDRESS OF CONSTRUCTION:
I :La(,' L ,,,,,t..r4d
(!ar
SQUARE
fOOTAGE: "
"bd
ESTIMATED COST OF CONSTRUCTION'
(EXCLUDING LAND VALUE)
CarOl
NAME OF lJTlLIlY EXCAVATION CONTRA ; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S}; AND/OR CDUNn WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE):
F;-g~~~~~~~~,';.~SIGNATION(S) Y. _ de.c1 T! rr..p~~E~ #2 ~79~ ~,6i~~;:.m :~;~oq \\ :
. " .- -- ~ ., 'I I
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:' l j) ~~ "': f I :! I
o SINGLE FAMILY ...I..2~~ CT""= :: r\\ 1 d III
o TOWN HOME !!9:"': ~ 0 M ADD 151> Plumber's Indiana State Licerise #: i MAR 2 9 ZO07 i Iii Ii I
o TWOFAMILY ,..llt~IYO ORCHADDmON(S) ,;, i"~ 1[0
# of units being p\P""'"' 0 /lECK ADDIT~~ . i W ,,; I . --.J
constructed at this --'^ 0 REMODEL s CASED ,... ' , I,
t;" {UJI' ~hf1i,.tI lJh1.~ _.. _I r-l""Whi.d:l~IUmbmg codes wIll be applied to the construction:
me: 't\(..~'" _Basemen"t'flmllll1:i!I'~1\ VI'fU 11\1e;, L_ _
o RESIDENTIAL (For U. 0 ACCESSORY BUILD~~v rnPI1ilRtJn ei'mlli~~'Ilii.llential Code w/lnil;ana limerfdmertts
Additions, Remodels, Etc.1 0 DETACHE~~,: date an"" W!t~jjJ.I"G"",":"IU.N '
o ATTACH1!9~GEJF Co '<...JJ.cJlIYf'Co: ......"""'IR>h~de w/lndlana Amendments
o DEMOuYtOrl OF C MMl.1J1I.ATNt:ades,
PROJECT INFORMATION: 'ARMEL I ~;;;.;~PE: (Check all that apply for the new
Early Release .-, Manufactured ./ IND / ~'fT"''fiO'1,,1 'lES
Permit: Y N Trusses: _Y 'N IANA 0 CR"A-OJ~ 0 POST & BEAM PIER
Lot Split: Y d Sump Pump: _ Y / N 0 SLAB 0 BASEMENT (WALKOUT:_ Y ----,N )
For Single Family and Two Family dwellings. additions, remodels, and/or accessory structures, this pennit is valid only if construction conunences 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 "Zoning Ordinance of Cannel 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
Occupancy has been issued b e Department of Community Services, Carmel, Indiana.
,fl'
Signature of OWner or Auth
ed Agent
OFFICE USE ONLY: *******************************.~******~*************7 "bi*7(J***** *************
INSPECTIONS REQUIRED: FIling Fees. ,---- -
, . Base Inspections: / J /. If 0
Upper Foo.tlng Lower Footmg Un ab ' " /:0
G? Cert. of Occupancy: , .j3, .J I
Rough Site
P.R,I.F.:
./
/)c...,M.I 1.)).',-1-.. "J/
Print
7/Y'07
Date
# Charged Re.
Reviews
.
Additional Fees
-$3 J.5.b()
~
(Date)
Reviewed/Approved: Dept. of Community Services
S:PermitsjForms{IlP RESIDENTIAL
~
Fee Received by:
Date