HomeMy WebLinkAbout07040180 Application
City of Carmel/Clay Township I'l\ldnITlnN=AiD#:0704~lEO
RESIDENTIAL IMPROVEMENT~Allfe1~PLICA'i['ION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory StrJ,ctures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER UTI
PROVIDER:
PHONE:
FAX:
NAME: e~-e.. A/It",
FlOOO ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
sI7-iooq.01lf3
STREET ADDRESS:
"372.0 ~/1'!1l }o,,\ 012.
CITY:
GC\..IM,-L
STATE:
IN
ZIP:
<7-(,033
01"\<<.(:'"
BEST METHOD OF CONTACT:
'1 110<7 I CO"^'-
PHONE:
?11- <(YJ-L440
BUILDER'S EMAIL ADDRESS:
D~u ~,v\(
NAME:
ObI'.
:5
FAX;
CITY:
STATE:
~tJ
STREET ADDRESS:
7 2.0 (\"N.'tl
lOT #: I SUBDIVISION NAME:
ADDRESS OF CONSTRucnON:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
/" time:
IlZI RESIDENTIAL (For
Additions. Remodels. Etc.)
?J
PROJECT INFORMATION:
Early Release
Permit:
_VLN
_V vN
S:PermitsjForms,fILP RESIDENTIAL
-J-c" L
Wood (tV\)5
,
SECTION:
ZONING:
37 2-0
SQUARE
FOOTAGE:
<{ r;LL
WATER UTILITY
PROVIDER:
r)~6i6'~-I~~~!
,."J.'l" .-., l !,
Iii '11
'I. III
':I.1i
.., )1'
161
I
j--------
:1 "!r '_,~, ,
ESTIMATED COSTlOf,CONSTRUCTION:1
(EXCLUDING LA. NO VALUE).' <.~ ; '.rl'
::' Iii '.Jf
Ilf'll i
,I ill
NAME OF lJTILITY EXCAVATION CONTRAcrOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE):
Lot Split:
APR
TYPE OF IMPROVEMENT:
a/' NEW STRUCTURE
g' ROOM ADDITION(S)'~
iU" PORCH ADDmON(S) ~
~ /DECK ADDmON(S)
LJ.I' REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
'II II,
TAX MAl PAR<4L #:
I
PLUMBING CONTRA€'FOR:
1/7#
Plumber's Indiana State license #:
Which plumbing codes will be applied to the construction:
o International Residential Code w/Indiana Amendments
o
Uniform Plumbing Code w/lndiana Amendments
Manufactured
Trusses:
Sump Pump:
V VN
V VN
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & 0./ BEAM ./ PIER
o SLAB 0 BASEMENT (WALKOUT:_V c/ N )
For Single Family and Two Family dwellings. additions, remodels, and/or accessory structures, this pennit is valid only if construction commences within 180
days of the date of issuance of the building pennit. and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. dass I
structure peunits are subject to the General Administrative Rules of the Sta.te of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any constructio ruction. en argern elocation, or alteration of a structure, or any change in the use of land or structures
requested by this application will compl t. and conform to, all applicable law f the State of Indiana, and the ~Zoning Ordinance of Carrnellndiana -1993" (Z~
289) and amendments, adopted unde uthority of l.c. 36~7 et seq, General Assembly the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen. bath. and floor drains are nnected to the sanitary sewer. I further certify tn t the construction will not be used or occupied until a Certificate of
Occup cyhas been issued b e Department of;? unity se6rvi~;OOe1, In iana.
, II- . 4- 'Z-J:: 07
Print Date
. I
* * * * * ** ** * * ** * * ** * * * * * * * * * * * * ?i*f ** *1 * * * * * ** * * ~* * * *
Filing Fees: ;2- I .3
Base Inspections: 1/7:;;/ so # Charged Re-
ReViews
INSPECTIONS D:
~er F~ Lower Footing Under Slab
c... KU~ Meter Base ~ ~
c;-s-- )rJ
Cert. of Occupancy:
P.R.I.F.:
Additional Fees
.5'"' z:-.?
(Date)