HomeMy WebLinkAbout07040171 Application
City of Carmel/Clay Township Permit #:~ I
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
STRtET) \AD~~ES. s~
4 '" I"'aVl L L~~ Q&.
CITY:
STATE:
IN
ZIPLj t:. 03 :L-
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
. OJrb'le.r @) c..orb',e.r1T~ ~-hb'l'\.S . (.,01"\--\ ~
PROPERTY
OWNER:
NAME'Cb\J~
STREET :rrtlss}J . €.-
LOCATION LOT #, ,j S~BE'::~ION NAMSE'
& PROJECT 'r In..,,,
INFO: ADOR4DFC;STMI~~
SEWER UTILITY (J WAlE TlLfTY J I I
PROVIDER' L-M-Me-I u.fi I PROVIDER, r!.-a.rMIl-/ u.n"
LLL
L;1<R-
cek....-
NAME OF UTILI1Y EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
~ Si
-+ 6'70'10/70
For Single Family ~lfld Two Family uwcllin,!!;s, additions, remodels. and/or accessory s"Uucturcs, this permit is valid only if construction commences within 180
, day.~ of the date of issuance of the building pt'rmit, and musr be completed (Certifil.:i\tl; of OCCUP,Ull::Y issued) within 18 months of thc issuanl.:1; date. Class I
structure permits are subject [0 the Gcneml Administrative Rules of the State of Indiana (See 6T5 lAC 12) regarding expiration time frames for heginning and
completing cOllstruttioll.
I. thl' undersigned, ~grcc that any constrL1ctiC1n. rCC\~nstrllClilm, enL!rgcment, n:10l::~!ti()n, or alteration of Cl structure, or any l.:hange in the use '11 bnd or structures
requested by this ,lpplicatillll wi/[ compry witn, and confoon tt], ,dll(flplicabJc bvs oJ lh,' Slille of Indi.lila, and the "Zoning Ordin~mce ll[ C"rmellndiana - 1993" (2:-
239) and amendments, 'ldopted under authority of l.e )6-1 et sect, e;cncral Assemhly of Lhc SClte of Indiana, and all Al'tS <lJTIcm!awry l!lerel(J. I further cenify chat nfll~l
kitchen, hJth, and f10m drain c conneCled tll the sanitary sewer. I further rntjfy th,tt the l.:onstruetil 1 'will not be used or un:npil:d llnti! ,\ Certific;lte of
()CC/l y hl: DcpMtmcnt of CUll1lnul1lty Sen lLe~ Carmel, IlHh,ma.
:JUrI ~.
Print
FLOOD ZONE AREA DESIGNA110N(S)
FOR THIS PROPERTY:
k
'--:-1'Crn \ -0.. \
TYPE OF CONSTRUCTION,- ~'lIjl3P 0 IMPROVEMENT:
~ SIN. ~LE-~.PJ"~1&: ~ ~ I = N~ STRUCTURE
o TOW/ll,H.~E~ ' d ADDITlON(S)
o TWO'F,AI;'IJL DOH ADDITlON(S)
\i~\o\V;;its being _ ,,'IS1J1 0 DDITION(S)
c_~nol!~cted i'b\l1ist ;) 0 0 EL
ti.'1'.e~ _ Ba ement Finish only
o RESIDENTIAL (For ACCES RY BUILDING
Addi'tidns.\Remo c.) HED GARAGE
\ \...\ '-' ATTACHED GARAGE
PROJECT\NFOR",AHO DEMOLITION
,----
Early Release ~
Permit: Y N
y /N
Manufactured
Trusses:
yV;;
/V=N
Lot Split:
Sump Pump:
Signature of Ow ro
orlzed Agent
E~v4-,'
P~Ti'i=: . )-~C
Plumber's Indiana State Lice~
tP SID 5s3fo!5J
Which plumbing codes will be applied to the construction:
~ International Residential Code w jlndiana Amendments
o Uniform Plumbing Code wjlndiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB ~ BASEMENT (WALKOUT,_y 0/'" N )
,~
(-23-07
Date
OFFICE USE ONLY: *********************************************************~***********************
INSPECTIO UIRED: Filing Fees: ::!ff20. ,10
Under Slab Base Inspections: - --
";t~ ) Cert, of Occupancy' SJ'
~
/d-&
(Date)
S:PermitsjFormsjILP RESIDENTIAL
Fee Received by:
# Charged Re-
Reviews
I
Additional Fees
I
Date