HomeMy WebLinkAbout07040098 Application
City of Carmel/Clay Township Permit #: 07()i-jo098
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
STATE:
ZIP:
NAME:
BUILDER'S EMAIL ADDRESS:
a.
I
BEST METHOD OF CONTACT:
:IN
~ ~
PROPERTY
OWNER:
NAME:
b
PHONE:
STREET ADDRESS:
CITY:
IN "
STATE:
IN
ZIP:
'Ii ~ fl.
LOCATION
& PROJECT
INFO:
SECTION:
3
ZONING:
$-
SQUARE
FOOTAGE: fo:J.O J
SEWER UTIUTY WATER LfTlLTTY
PROVIDER'(. " PROVIDER: C
NAME OF lJTILrTY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE):
ESTIMATED COST OF CONSTBucnON:
(EXCLUDING LAND VALUE) n :)57
o
D 704 CXf17
Jh" C
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TAX MAP PARCEL #:
.~ '\ ~~l
TYPE-OF CONSTRUCTION: I :Pip' ~OF1:MP . NT? f:".O PLUMBING CONTRACTOR:
/ \~ll ""E\\\' vCo 'A""~ .
Il!I SINGLE FAMILY " IN '" CTtIR~",<f/),D;'iIlJ ~, E SMI TH
~ ~~~~~~~ ^? Po' .~~rh~0 "1')0' te 'lI1.'N a <iif iana state License #:
# of units being " -'i ~~ D~CK'AD'nio1l\(~?l1M(;:,O':;i11 Z !o
constructed at th~S ~:i 0 REtlODEIl ,jl1f2Z ,,'Ile.. co" O/)ft" " "
ti 'I ' ~"""-' t F'n/ h . tvl C wttl IUmbmg dfC!IIes Will be applied to the construction:
me: . . /-:,,-, _Base~en I ~~,.'qr;- .f 1. C::.;Qth /.. . i
o RESIDENTIAL(For <-."~," 0 ACCESSORY BUILDINerl/lf -', . ,'Intel'ii8tlDoa1 !l-esldential Code w/Ind,ana Amendments
Additions.\Remodels, Etc,)' O""DETACHED GARAGE ",<j V~':'l)' " ,
\~ "l. _~?,,"'5" ATTACHED GARAGE 0 Un nllQI~bmg Code w/Ind,ana Amendments
PROJECT INF&RMATIONr'" 0 DEMOUTION FOUNDATION TYPE: (Check all that apply for the new
Early Release\;::->."-- / Manufactured / construction area)
Permit: yy ~N Trusses: lL};.y NN 0 CRAWLSPACE 0 POST & BEAM PIER
Lot Split: Sump Pump: VY 0 SLAB (l1('BASEMENT (WALKOUT:_Y ~)
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 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.
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
Oc upancy has been issued by the Department of Community Services, Carmel, Indiana.
" '
lD~; A, B;\\'b5llkXT - J.lENI; 1Jt:
Print
</11I/tJ7
Date
~
OFFICE USE ONLY: ********************************************************r*ii*******************
INSPECTIONS EQUIRED: Filing Fees: /0;2.,--,- ()
F t' L F t' Base Inspections: ;Z If? SrJ
pper 00 In wer 00 mg
Cert. of Occupancy: , -:; (), ) 0
PC:: / !~L: J ~ IJSt02 ~ /OionalFees
~f:C~~e~
# Charged Re-
ReViews
'-x:JjApproved: Dept. of Community Services
S/forms/ILP RESIDENTIAL
(Date)
Fee Received by:
Date