HomeMy WebLinkAbout07050028 Application
'\
City ofCarme//Clay Township Permit #:f)70!)W;rb
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
AVlu\:' L.
STREET ADDRESS
210'2.... S.I-+t4--eblu'o ~
a4::JILBCR'!; [tlAIL !,BBm;~~ fAX
L.<6to -\~O,
PHO~E
<..o3B-'13'2.
FAX LoSL.:. \ SO
CITY
.:cJ... ~u.
STATE
"J:LI
ZIP
Y t... 'I.:I.
BEST METHOD OF CONTACT:
BIZ' tiLl S~
Q.EL'- (;'2-,- 28lY
FAX
$1'-\ SC\ \ '1
PHONE
W\C.K De.ve:LOf' "1€"L''l S,l.\ 'S.'\O:::>
PROPERTY
OWNER:
NAME
STREET ADDRESS CITY
E .l-l-E.10 M~~' S'l CA~Ml2:'-
STATE
~
ZIP
Lll.:.03'2-
LOCATION
& PROJECT
INFO:
LOT #
SUBDIVISION NAME
SEmON
ZONING, 5 _ I
SQUARE
FOOTAGE'~B au 0
SEWER llTILITY
PROVIDER, SeR"Tl c...
s-r
WATER UTILITY
PROVIDER: W eLL-
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) 4BI~
NAME OF lITlLITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY ~..:-~~~~DI?' SEPTIC PERMIT #'5 (IF APPLICABLE): -
F R ,-rr~j \:?,. \ E\\ PLUMBING CONTRACTOR:
SIN.Ci~ff~,~~~Jf::;.-::"'----- STRUCTURE
TOWN 'ii?ME- ~. OM ADDIl10N(S)
TWq"rf_.M.~Y~, r." 7.()()1' CH ADDIl10N(S)
# o\\0(t;;'~A~ E ODEL
o MUL 1\ 1~Al\1'i\L Y AC SSORY BUILDING
# of Villt%~_ Q..- CHED GARAGE
o RESID NTIA or ...._______0. ATTACHED GARAGE
Additio ,Remodel:) '5(. DEMOLITION
PROJECT INFORMATION: / "-
Early Release Manufactured
Permit: _ Y _N Trusses: Y N
Lot Split: _Y _N Su~ED Fq.R CQ~ST~llQ~~LSPACE B :~~M&E~~AM
!':lIbiect to c2ln.!ililance Vllt, I all, e0dlu\\9'M'!;
Does any part of the property lie wiffilrr a S!\f~rntf)lgM 1!~~,~'\'!M~j1rea: _Y _N WALKOUT:_ Y_N
For Single Family and Two Family dwellir0~t~ ~M~;G"c~UJQfti s, this permit is valid only if construction commences
within 180 days of the date of issuance jio(fWv+l.~~f!{Wrf.U1d ~et9~;:~rr&M'4€3:'H.tftRate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits a~~M~e~&; tl1'~cneHi1f5;:dImnI~trative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
time frames for ll~~mt completing construction.
t, 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 \\111 comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
lndiana - 1993~ (Z- 289) and ardj,ndments, adopted under aurhoriry of f.C. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
there . I rrh r certify that 0, y kitchen, bath, and floo:s.dr:11n e connected to the sanitary sewer. I further certify that the construction will not be
use or oc p. d until a Cer 'ificare of OccupancyhaSoeen issu d by the Department of Community Services, Carmel, Indiana.
-5 i~
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
o International Residential Code wI Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
s(~ 0\
Date
OFFICE USE ONLY: ********** *** ** ***************************************************
I 0 . , Filing Fees: / 3 15 ' t; 0
INSPECTIONS REQUIRED: I " ~"7 5~O # Ch d
Base Inspections: . .l-l-' _ arge Re-
Upper Footing Lower Footing un(ger Reviews
Cert. of Occupancy:
Rough In Meter Base Final Site
P.R.I.F.: Additional Fees
TOTAL:
pproved: Dept. of Community Services
S/ILP RESIDENTIAL
5//~/ &7