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HomeMy WebLinkAbout07040218 Application City of Carmel/Clay Township Permit #: CJ 7oLfolJe RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures BUILDER OF RECORD: PROPERTY OWNER: LOCATION &. PROJECT INFO: NAME: NAME: STREET ADDRE <;( ~(. FLOOD ZDNE AREA DESIGNATION(S) FOR THIS PROPERTY: ;'B:;.;rVjN 'Elp~e O/-€ mON: O(jfN >1c:J~ 7; SEWER UTIUTY ~, WATER UTILITY /")"" F.' _ d PROVIDER: L f f- C>'\-I PROVIDER: L-OJ ~ NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / aZA I BPW DOCKET NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABlE): TYPE OF CONSTRUCTION: ~ SINGLE FAMILY '~WN HOME o TWO FAMILY # of units being constructed at this time: o RESIDENTIAL (For Additions. Remodels. Etc.) PROJECT INFORMATION: Early Release Permit: Lot Split: _Y~N _y~ TYPE OF IMPROVEMENT: CIY1IEw STRUCTURE o ROOM ADDITION(S) o PORCH ADDITION(S) o DECK ADDITION(S) o REMODEL _ Basement Finish only o ACCESSORY BUILDING o DETACHED GARAGE o ATTACHED GARAGE o DEMOLITION Manufactured Trusses: _~N _YXN PHONE: )7 f -to 0 C> CITJ1 ~ ~: LtV Y-A/ FAA:~ 7 J - i DItf ZIPfC() J2. C6'V BEST METHOD OF CONTACT: >o-rJl- 300 C' e (/ Sump Pump: PHONE: FAA: CITY: STATE: ZIP: SECTION: o~ u1 ZONING: SQUARE o. 7 Q- FOOTAG~b /J ESTIMATED COST OF CONSTRUCTION; (EXCLUDING LAND VALUE) '2 a tfTzJ. hJ ." TAX MAP PARCEL #: " '/ i II i\i! PLUMBING C~HT.RACT.& ,S h 'dJtJ,ktt-J Plumber's Indiana State License #: PI 70'1-0-C/& j i.UUI 1'1 I ~ i J'!' II, .....-;' , ~I Which plumbing codes will be applied to the construction: 9i International Residential Code w/Indiana Amendments o Uniform Plumbing Code wI Indiana AmeJ:\~ents :\\V FOUNDATION TYPE: (Check ill~~\for the new construction area) ~\c:,' a<:(.'" "- Q\~ ,\\ <:.';:> o CRAWl5P~ G~\'lIo~6~M#PIER % s~~Q;5 ~'{fA 't~~l ~ N) For Single Family and Two Family dwellings, additions, remodels, and/or accessory structure~ " . ~f ~% stftk::~ commences within 180 days of the date of issuance of the building pennit, and must be completed (Certificate of Gee . .jssure~~~~ApY<L~~ issuance date. Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 6 IAC 12).J~i\.~~\AA ~~ frames for beginning and completingconsrruction. (;.;<?' C~ \~V\ I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alterarion of G:~~Xor any change in the use of land or structures requested by this application will comply with, and conform to, all applicable laws of the State of Indiana,.a~ ~e"ll'2:oning Ordinance of Carmel Indiana -1993~ (z- 289) and ame ents opted under aut ority of l.c. 36 er seq, General Assembly of the State of IndiahJ, and all Acts amendatory thereto. I further certify that only kitchen, ba , '!l fl r rains are conn ed to the sa sewer. I further certify that the construction will not be used or occupied until a Certifica.te of Occup yh be ,uedb artmentof uni e "C/~C p,~ cu'~c:Jz=, 0-2 {-o 7 Print Date OFFI E USE ONLY: ******************************~~**********************?*J~****.9U************** INSPECTIONS REQUIRED: FIling Fees: 6 L2, 0 ~'- L F t~ U d SI Base Inspections: r2. 8i;7,S'o er 00 ower 00 mg n er a S () (M. Cert. of Occupancy: 5, 0i ugh I ~ter B~ inal 'Site P.R.I.F.: / r;) hi Go ~~,;27?750 Fee Received by: Date :Y-<- 5-1..--01 Dept. of Community Services (Date) S:Permits/FormsfILP RESIDENTIAL # Charged Re~ Reviews Add;bonal Fees