HomeMy WebLinkAbout07040090 Application
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City of Carmel/Clay Township Permit #:~a
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
NAME:
b
dml!'~
BUILDER'S EMAIl ADDRESS:
,
er/~p~
PROPERTY
OWNER:
.6A- .4-
,/J1t:
LOCATION
& PROJECT
INFO:
STREET ADDRESS:
/CJ ?7.5
LOTI:
S
ADDRESS OF CON$TRurnON:
:;;;an?<!:
F"/~GG
SEWER LJTIUTY WATER UTIlITY
PROVIDER: C;/~...p. PROVIDER: e';;rm,,/
NAME OF lJTlUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
----_.~-\
TYPE OF CONSTRUClION:;.:;;r:;,\ TYPE~OFIMPROVEMENT:
o SINGLEFAMI[~<<~ ~.Y-~~~Nt\v~RUCTURE
o TOWN HOME, ~-;:::.-~ iit" R~<?M, ~DDITION(S)
o TWO FAMIL'Ij \ ~ PORCHIADDITION(S)
# of uM;(~~ing 'Do ,2 2eel DE,~~A,ilpITION(S)
constructed'at tl1ill \\ 0 REI'IODE~
/ time: \ \ \ \ \ \ ~ Basement Finish only
rF1' RESIDENTIA~.(For ___--- 0 ACCESSORY BUILDING
Additions) RemOde'ls. Etc.) D_DE'fAcHED GARAGE
L---o ATTACHED GARAGE
PROJECT INFORMATION: 0 DEMOLITION
Early Release
Permit:
Lot Split:
Manufactured
Trusses: _Y ~N
Sump Pump: _Y /N
_Y_N
_Y_N
PHONE:
..:f 9 ch:J 7 "l:t-
FAX:
,y{Jd--~.>~/
ZIP:
~v,,'7Y
CITY: STATE:
c~1' ~,/.:/
BEST METHOD OF CONTACT:
C:<!:-//
PHONE:
'78- ,t,.1f"t?.!}
FAX;
CITY:
C:.iN??6/
STATE:
ZIP:
-f/'~#.?,;t,
w
SECTION:
ZONING:
,$-/
SQUARE
FOOTAGE:
ESTIMATED COST OF CONSTRUcn~
(EXCLUDING LAND VALUE) ~ '.?" 4 t? () 0
TAX MAP PARCEL #:
PLUMBING CONTRACTOR:
"v;;Y~
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
o International Residential Code wI Indiana Amendments
o Unifonm Plumbing Code w/Ind~~~~~:ents
FOUNDATION TYPE: (Che~~~~~~y for the new
construction area) O~ro v\ \0Q;v ro
o CRAW~o~:~~~~~PIER
va::~~\~~ ~~Y N)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory struct ,. . ECP c l(~n conunences within 180
days of the date of issuance of the building pennit, and must be completed (Certificate of cy i&t l~nt ~~e issuance date. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 IAC~G~ard.ig l~~ e frames for beginning and
compktingco",truction. ...,.~\' (jP' \~
I, the undersigned, agree that any construction, reconstr' largement, relocation, or alteration ~a e, or any change in the use of land or structures
requested by this application will comply with, an nfonn to, all app . le laws of the State of Indi~ the "Zonmg Ordinance of Carmel Indiana ~ 1993" (Z-
289) and amendments, adopted under authori l.c. 36-7 et seq, General embly of the State of In~na, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and or drains are connected the sanitary sewer. I further ce ify that the construction will not be used or occupied until a Certificate of
Occupancy en issued by the Depar ent of Communit ervices, Carm I, Indiana.
OFFICE USE ONLY: ***********
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~ Y:/Z-t?1'
Date
# Charged Re-
ReViews
Cert. of Occupancy:
)'S" .:;1)
'~~
~~
[:J
ReviewedjApp ved: Dept. of Community Services
~""ml"/F"m'/ILP RES")'N:'AL
Fee Received by:
I
Additional Fees
;f 4;.. -If; 00
Date