HomeMy WebLinkAbout07050013 Application
City of Carmel/Clay Township Permit #: 070500/3
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:
PHONE: FAX:
RE~HSElI5'iftDE)CONSTRUC -?5?(P~
6u~t tD compliance vJitr51lA'rwgulations ZIP:
:::c..-- \3:lpte 81id Lc GgiJArJQ €S. '-/(.,~8D
.1"6"1'1 r~J,\ NtASERVICES
~ i\cCl~F CARMEL~ TOWNSHIP
INDIANA
~ L\...c...
STREET ADDRESS: ~
LAA9~ f. ,"7'5- '5\,~'-Ioo
BUILDER'S EMAIl ADDRESS:
e\\"/"c"\x\-"'SW0,.,,"
'"
NAME:
~"-oDr
~,
ll.f.
STREET ADDRESS:
LA.A..lt [;.."'7 "5.... "Z:::\-.""'"' '(Do
LOT#:
SUBDIVISION NAME: - G
U c:.,\S 'W
L('~
PHONE:
FAX:
STATE:
-::r::,0,
ZIP:
411~ 9:l
cnY:
\S'
SECTlON:
ZONING:
ADDRESS OF CONSTRU01ON:
3~ 0 W,,,-,,^-
WATER UllLnY
PROVIDER:
SEWER lfTIUTY ~
PROVIDER: L \ 'f-. W1>
K0V"\.
\
SQUARE Ct
FOOTAGE: 5"fl I
rn'L 0 -
__olO:::..?I,:~
SD\\7:'~ ~Jf6*e6~~ \\ ~
TAX MAP'PARCe.' ~ #: 200' .\"\\1. 1\
\li'll! MAy-2 'I I\JiI
11' 1\1 \L.--'
PLUMBING CONTRAaOR: -'
" \.... -L-
L'J ,\\~e ';'1~\,-,,,,,\n159
Plumber's Indiana ~te_l.icense.#: -
~\ 02:>Di:::><J'1
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATlON{S)
FOR THIS PROPERTY:
TYPE OF IMPROVEMENT:
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
1St
o
o
o
o
NEW STRUCTURE
ROOM ADDITION(S)
PORCH ADDITION(S)
DECK ADDITION(S)
REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_yLN
_V .,IN
Manufactured
Trusses:
Sump Pump:
LY_N
LV_N
J
Which plumbing codes will be applied to the construction:
~Intemational Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB ilY'BASEMENT (WALKOUT:_V_N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit 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. Class I
structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
completing construction.
I, 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 conform to, all applicable laws of the State of Indiana, and the ~Zoning Ordinance of Carme:llndiana - I993n (Z-
289) and amendments, adopted under authority of I.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bat and floor dra. s are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
cy been issue e epartment of Community Services, Cann I, Indiana.
s;
..frJ - Of
Date
OFFICEUSEONLY:*********************************************************************************
INSPECTIONS RE UIRED: Filing Fees:. . !if., '7 !2(}
~ B I ct <" ,~ "' # Charged Re-
F . F t' Under Slab ase nspe Ions. 0 /. ...
per 00 g ower 00 I , F"S. <() ReViews
Cert of Occupancy: -2 J .
~h ~ .......,i!r !Sase J ~ - Site)
'--_ -"" ___________ P.R.LF.:
S-- /U'7
Services (Date)
Reviewe
S:Permits/FormsjllP RESIDENTIAL
Fee Received by:
Additidnal Fees
tgj,?()
Date