HomeMy WebLinkAbout07040121 Application
,
,
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER UTILITY (\
PROVIDER: \.-t.J.-\
City of Carmel! Clay Township Permit #: o ryDLf OJ 2- L
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
NAMEPGLL1(
m6S
79
STREET ADDRESS:
NAME: 8
STREET ADDRESS:
PifYl6
SUBDIVISION NAME:
lLlJ\&6 OF WBST
NSTRUCTlON D TS WOO [)
WATER UTILITY C
PROVIOER Ai2.Jvil::; L
FAX:
STATE:
ZIP:
cm:
SECTlt({) 0 0
ZONING: .s-l
SQUARE '3
FOOTAGE: 51
ESTlMATED COST OF CONSTRU
(EXCLUDING LAND VALUE)
Kt6
Iff)
A .1 SLLPtiLI Or2- Ei'i C- -
120 TAX MAP PARCEL #:
J'1 -09 - /.(f- DO-tf-!::i- - 010,
PLUMBING CONTRACTOR: . I
~ rY\ ~-SON~, IN G
Plumber's Indiana State License #: .
c-p 10000 I 0 (
-u
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
" .-:",;:3~-~'~;\"\\
_. fI IX.';. ,II
TYPE OF CONSTRUCTION:---,\S;, ',:,:rvPE';OF'IMPROVEMENT:
/ .--< iF. ~ / \II \II
~ SINGLE FAM. I~Y ("?, ~_- C3Y~W ~1,l.11<;1:URE
o TOWNHOME,_'\ ~ c::},{ OM'ADDmON(S)
o TWO FAMIL V\\\ \ \ '€J V ORCH ~oDriI.ON(S)
# of units'~eln~ \ ~'?~ 0 DE,9<-ADDITION(S)
c.onstructe<!'at-thls ~D REMODEL",,-------
tIme: 1\\ \\ \ Basement Finish only
o RESIDENTIAL (~~r '\::,\ /: 0 ACCESSORY BUILDING
Additions. Remod~ls. Etc.) ~0"--DETACHED GARAGE
\ ~ 0 ATTACHED GARAGE
PROJECT INFORMATION: 0 DEMOLITION
FLOOD ZONE AREA DESIGNA TlON(S)
FOR THIS PROPERTY:
Which plumbing codes will be applied to the construction:
~temational Residential Code w/Inoiana Amendments
o Uniform Plumbing Code wjlndiana Amendments
~y~
~y ~L..-N"
FOUNDATION TYPE: (Check all that apPI.x..~~ new /
construction area) F ( tJ IS 116 D V/1K-l11tL vJ B41/t
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB ~ASEMENT (WALKOLrr:~Y V<;
Early Release
Permit:
Lot Split:
Manufactured
Trusses:
Sump Pump:
v< N
vr' N
_.------
For Single Family and Two Family dwellings. additions, remodels, and/or accessory structures, this permit is valid only if,c?~s~cti~'c~~~c~s~'0t~}~b "
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within;18 m,ql}thsJof-tlie issuance date. -<;:lass II \ 'I',
structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding exp,i~.a~ion time frames for beginni~g ah~ I \ \
completing construction. L I '\ 1 11 I ! \ I i
I, the undersigned, agree that any construction, reconstruction, enlargement, relocatIOn, or alteration of a structure, or any ch:ll~ge in the tbMlan& o&t;{QQ1~s ' '\ ' \
requested by this applicatlon will comply with, and con. form to, all applicable laws of the State of Indiana, and the ~Zoning O~dina\.ic~ of ca~~!. Indiana - 1993"I(Z- 1\, LJ '
289) and amendments, adopted under authonty of I.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts ame~<!~to&Lthereto. I further certify_~!i~~_orily-
kitchen, bath, and floor drains are connected to the samtary sewer. I further certify that the construction will not be used or occupied until a'Certificate of
oe:~:~eYhas be'll issued by the Dep;<2f Community Semees. :W~~ E, 3HEPH8~8-----:--111'L /01- _J
,Signature 0 Owner or Authorized Ag t Print Date
USEONLY:*****************************************************~**************************
INSPECTIONS REQUIRED: Filing Fees: 5/9/7 /0 I
. _ Base Inspections: ..:=:2 /5"7 ({J # Charged Re.
Upper F150ttn 0 er Foot'" Under Slab ._ ~ A Reviews
Cert. of Occupancy: 5) J v
P'R~I.F.: /."..{ C/ 00
- TOTAL: ,/J 8::;(, O! I {J
~e2;~~
Fee Received by:
Rough er a
tJ JL i1JJt
o
Final
Site
Additional Fees
Reviewed/Approved: Dept. of Community Services
S:PermitsjFormS/IlP RESIDENTIAL
(Dale)
Date