HomeMy WebLinkAbout07040155 Application
City of Carmell Clay Township Permit #: 0'1 ({)4tJ,5 5
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two.F~mM~s~ ~b~~~~OdeIS: & Accessory Structures
NAM.E:/ I sc,' 1Betto. om~fllf1l~ewl /1" FAX:
WOOcMlu-- C ) 01."'"t8 nd Loc . V S\f>ci-l)
STREET. DRESS: [:EP I OF Cub'rf.IUI'2 ~"E: ZIP:
TY OF CA:"liipU~Gi, Y62J')1
i i\1 0 METHOD OF CONTACT:
;;;'1L'~cPd8' /
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
BUILDER'S EMAIL ADDRESS:
cluJo[)AcJ!r~ ;;;
NAME:
6z,(.-
STREET ADDRESS:
]660
FLOOD ZONE AREA DESIGNATlON(S}
FOR THIS PROPERTY;
LOT #: SUBDIVIJION NAME: f
~J / vi, 4- e: D Vl)esl-
ADDRESS OF CONSTRUCTIo/(
17 i t..<>
SEWER UTIliTY WATER UTI~ tJ
PROVIDER: CT (<. W D PROVIDER: C'~
NAME OF UTIlITY EXCAVATION CONTRACTOR; PlAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
TYPE
F CONSTRUCTION:
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
yVr.
yV<
6/uJ CITY:~~
S'+
TYPE (}Ii IMPROVEMENT:
~EW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
~
Manufactured
Trusses:
Sump Pump:
j-
PHONE:
FAX:
S-7 I - V () 2 I
STATEr
~oj
~P~3 L
SECTION:
)1-00'2...-S
ZONING:
L~ '<:::,
SQUARE
FOOTAGE: q ~1k
ESTIMATED COST OF CONSTRurnON:
(EXCLUDING LAND VALUE) cr (:)0 DoD
lit C AA ',)~ ,n:::/T' k.fdJJ~ri \~\, :Q'flI'.f9," ,~()
"--1,1,1 -...;).~---1.
TAXMAPPAithi'1 ill iil
PLUMBING CONTMcr6'R: J l.l:V1'
A ,t< ,,) '-C t}-c;",;;---Ptz-v--;-!;-:r;;-6
Plumber's Indiana State.Ucense #:___ .
PC 'X'?1 ''00o:f()
1
Which plumbing codes will be applied to the construction:
o International Residential Code wI Indiana Amendments
~iform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM _PIER
o SLAB ~EMENT(WAlKOlJT:_C.t::::N)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is valid only if construction commences wi~hin 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 pennits arc subject to the General Administrative Rules of the State of Indiana (See 675 LAC 12) regarding expiration time frames for beginning and
completing construction.
t, 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 confonn to, all applicable laws of the St2te of Indiana, and the ~Zonjng Ordinance of Canne11ndiana -1993" (Z~
289) and amendments, adopted undet authority of LC. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory theteto, I further cettify 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 by the D partment of Community Services, Cannel, Indiana.
\ ~(e l\/OOJ-u II
o
Signature of Owner or Authorized Agent
OFFICE USE ONLY: *****************
pper Footin'ower F
ough In ~
R
S:Permlts/Forms/ILP RESIDENTIAL
P.R,LF,:
Fee Received by:
<../ In 107
0.'" I /,
# Charged Re.
ReViews
,
Additional Fees
Date