HomeMy WebLinkAbout07040129 Application
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City of Carmel/Clay Township Permit #: () 7 ()~{)!Z1
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
NAME:
PROPERTY
OWNER:
STREET ADDRESS:
LOCATION
&. PROJECT
INFO:
LOT #:
SEWER UTILITY ~
PROVIOER: . ~<Jr~ GrR.
ZIP:
fAA: ~~'-'I jrT'ON
PELJ::PSED FOR C "k.: ,', ,.,. '.
. . . ,,:.h ';.Ii 'CJ:111~,'11C)ns
/I 5.rTY:~ A /UUiVo, ~f S RO L'~'Gc' S.:.?;~I~.
(.-<<..rr//k-l ._ "",':';'1'&'''',#'~ES
't..':, dfe'ft.RMEL; "t9~I,NG:UNNS~
, . ~' .'\
PHONE:
.l td~;f/ tit
.5'a~ tt5 ~~ZU
SQUARE
FOOTAGE:
WATER UTILITY ~._.
PROVIOER: Ld.r IJ<.d
ESTIMATED COST OF CONSTRUcnON: -J
(EXCLUDING LAND VALUE) / 0 cr CJ 0
(?<J
NAME OF UTILITY EXCAVATION CONTRAcrOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATlON(S)
FOR THIS PROPERTY:
TAX MAP PARCEL #:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
/' time:
[s;( RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
~y:i1N
~Y~
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o fll,OOM ADDITION(S)
~ PORCH ADDITION(S)
III DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
Sump Pump:
~Y --.2fN
~Y XlN
I C\
P&BING CONTRACTOR:
.1(
Plu ber's Indiana State License #:
Which plumbing codes will be applied to the construction:
o International Residential Code w/lndiana Amendments
o Uniform Plumbing Code w/lndiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE ~ POST & ~EAM _PIER
o SLAB 0 BASEMENT (WALKOUT:_Y_N)
For Single Family and Two Family dwellings, additions. remodels, and/or accessory structures, this permit'isvaLd ~nJY if construction commences within 180
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy issued) 'iwithin IS months of the'issuance date. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 CAC 12) regarding expiration time frames for beginning and
completing construction. c ,:. :
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure: or, any c^<Jh~ infh~sflpfl~nd or structures
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the>,Z6ning cfr'dinance of Ca~enndiana - 1993" (Z~
289) andlamendments adopted underauthotlty of 1 C 36-7 et seq, General Assembly of the State of IndIana, and all Acts amendatory thereto I further certily that only
ht~/ba[h, an floor drams are connected to the samtary sewer I further certIfy that the constructlOn will not b~ used or occupIed untIl a CertiuC3te of
~ '
Oc cy has em I,"ued by the DepMtment of Commurnty Semees. Carmel. IndIana ~~
~. tJk5 U/#'e-,("E:L -----~- //;/07
Print Date
OFFICE USE ONLY: ***** *************************~~*************** *******,******* *(1** ************** *
INSPECTIONS REQUIRED: FIling Fees: It-~. :)
Base Inspecti()ns: / /}) <' (J
.
Cert. of Occupancy:
Meter Base
Lower Footing
Under Slab
S:Permits/forrnS/ILP RESIDENTIAL
~
~
P.R.LF.:
/
~/, 'Z7 '07
(Oat
<;5,
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# Charged Re-
ReViews
Additional Fees
("0
TOTAL:
~;:3 10,
Fee Received by:
Date