HomeMy WebLinkAbout07050026 Application
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City of Carmel/Clay Township Permit #:Q7~aCo
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: ('1\\-, ~('I'r\e-\ c,<\'i:>*('~c..-\;an
JEET ADDRE~ . I
'3~ "t5 -r-IJ,';/P,~ .>-r-.
NAME:
!::>Du
STREET ADDRESS: 1'0.3180
/)J;rdemlf~
LOT.: 90
PHONE:
317- fJ'/'-I-791&
CITY Uz 01) d
FAX:
3J7- fJ'I!-JY6
ZIP:
Lf (ij J-
~
STATE:
-=:t:7tJ
BEST METHOD OF CONTACT:
or
FAX:
STATE:
ZIP:
l-f /PM )--
ZONING:
3;)0
SEWER UTlUTY ., I A _ WATER lJTIUTY '
PROVIDER: ~ PROVIDER: "'-.\ ftr
NAME OF UTILITY EXCAVATION CONTRACTOR; PlAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPT1C PERMIT ,'5 (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
0If RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
_v ~Cf'll:;rured _v.1N
_V LN ''4I!/IJJ.~ ~ N
Early Release
Permit:
Lot Split:
I-\t\
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
g, ROOM ADDITION(S)
[!j PORCH ADDmON(S)
er DECK AOOmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
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Which plumbing codes will be applied to the construction:
o International 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 e- POST & L BEAM ~PIER
o SLAB 0 BASEMENT (WAlKOUT:_V_N )
For Single Family and Two Family dwellings, additions, remodels, .e.~gry 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 afi'tificate 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 !ication will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana - 1993" (Z-
289 (; dm p0yado d cler authOrity of LC. 36~7'et seq, (Jenera!. sembly of the State of Indiana, and all Acts amendatory thereto, I further certify that only
kitc e CI. o6r~ . re ~cted to the,sanfrary sewer. I further c tify that the construction will not be used or occupied until a CertJfica.te of
rpancy been iss y the De tment~f Co unity Services, Carm I, Indiana.
. / lJak ~.fiy f?..,)-__ lflc3iJ)tJ7
, .
Signature of Owner or 0 Agen Prin,t Date'
OFFICE USE ONLY: **********
******************
Filing Fees:
Base Inspections:
Cert. of Occupancy:
P.R.I.F.:
Upper Footing lower Footing
M
Meter Base
<-.
Reviewed/Approved: Dept. of Community Services (Date)
S;Permlts/FormS/IlP RESIDENTIAL
# Charged Re-
Reviews
TOTAL:
Additional Fees
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Fee Received by;
Date