HomeMy WebLinkAbout07050043 Application
i
i
City of Carmell Clay Township Permit #: 07 () 5odf.(j
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
PHONE:
FAX:
STREET ADDRESS:
(.Jco g ~
o
~-7Y -/
CITY:
'Jv'O.-...! ...l./Ir ~
f illEST METHOD OF CONTACT:
Ale. 0 -
1j..(.<J{-
0.3
PROPERTY
OWNER:
BUILDER' EMAIL AD;rESS~ .
<A.J~,N.
NAME: 5-1A,./.... ~r'O
?
PHONE:
FAX:
STREET ADDRESS:
CITY:
STATE:
ZIP:
LOCATION
&. PROJECT
INFO:
LOT#:
3<>1
SECTION:
ZONING:
Vi'
yO
SQUARE 1)
FOOTAGE I u JJ /6
SEWER LJTIUTY _11
PROVIDER: C rt<WO
ESTlMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
/Z
NAME OF UTIUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'$ (IF APPUCABLE):
b-1Afl" er~f7~6
TAX MAP PARCEL #: t 0706co
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR: 1
~~~~~~~~~(S) Plui~r~~dia~~~se f~ ,I\J (
o PORCH ADDmON(S) t9c.
o DECKADD~~ _p t- 8' 0 J-lSOO~ ~
o REM~~:;~tUWe" ~~ f:; Which plumbing codes will be applied to the construction:
o ACCESS RY BUI~Gotn O~~tional Residential Code wlIndiana Amendments
o DETACH Gt St PItCiI7 .z:&.."_h
DATTA A". Cite Ci17d . i/'-"<.1'C'r~ng Code wI Indiana Amendments
o DEMOL rOf: CO'_ (O~~CiIl , OM
PROJECT INFORMATION: C/jr.. ;v/!v7U/V i:tWt~I>'I:: (Check all that apply for the new
Early Release /" Manufactured"'/Vf~ CI ~I~ area I;
Permit: _Y ~ Trusses: _Y ~DIAN !.AY" t~ACE POST&_BEAM ~PIE~
Lot Split: _Y ~sumpPump: _~ N f1 ~I BASEMENT(WAlKOlJT:_Y~
ONSTRUCTION:
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 pennie, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structute 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 Cannel Indiana - 1993" (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, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Oecu has been ~ ,he Dep' 'men' of comm7ervices, Carmel7diana(~ vJ ~ D~ <-(/1 b !u 1
Signature of Owner or Authorized Agent Print Date ( (
OFFICE USE ONLY: *****************t*******~f.**** *****~************h-*J*/~***i:1:A******************
INSPECTIONS REQUIRE ~ Q) '1i DFII 9 Fees. f 1-'1/ (JU
~er F~9 Lower Footing U der Slab II'" se Inspections: '.;2 }! ~ 0 # C~:~~~s Re-
~~ Meter Ba J --, "/, A A
_ <X- "" U () Additional Fees
/if ~ TOTAL: ff :5 ()7"5':cfO
Reviewed/Approved: Dept. of Community Services (Date)
S;Permits/Forms/ILP RESIDENTIAL
Fee Received by:
Date