HomeMy WebLinkAbout07040195 Application
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City ofCarmellClay Township Permit #: 0 '7o-/Dl q6
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:
'h~""-1I"'I\5 CoI0'\
STREET ADDRESS:
\\\'0 D 0M)"'-<'
BUILDER'S EMAIl ADDRESS:
.J
\~~i>.~
. ~o"'\..
~S'0L...'
PHONE:
~n CJS'O";:,d"lo\
FAX:
cm:
STATE:
~;:;\ \
:>;;"'-
.--.?;
SQUARE
FOOTAGE:
ESTIMATED COST OF CONSTRUGTlON~--,,-.~__
(EXCLUDING LANDVALi~1)-1) p~ (~~-;19~n \'Ob8~~~:;\'1
II~~{I :111 iii
TAX MAP PARCE1LY: UL_ liU)1
PLUMBING CONTRAqOR: _____.J j
""'~
Plumber's Indiana State License #:
SEWER lJTIUTY WATER lfTILITY
PROVIOER: QJ:>..~\\ "" \- PROVIDER: Q..A, :\I "-
NAME OF UTIllTY EXCAVATION CONTRACfOR; PlAN COMMISSION I BZA I BPW DOCKET
NUMBERS;-TAC.DATE(S); ANDIOR COWTY WELL ANDIOR SEPTIC PERMIT #'S (IF APPLICABLE):
~ - .;--.....
~QO~Er~--1PESrGNATION(5)
FOR'!.THIS'PROPERTY:
TYPE OF CONSTRUCTION:
(l( SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
~ RESIDENTIAL (For
Additions. Remodels. Etc.)
Early Release
Permit:
PROJECT INFORMATION:
-y-b
_Y~N
Lot Split:
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o DECK ADDmON(S)
!2(' REr,tODEL
1- Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
Sump Pump:
Y~
:0=N
~(' _ 66'2>bDd-~"3
Which plumbing codes will be applied to the construction:
o International Residential Code wI Indiana Amend~ents
I
~Uniform Plumbing Code wI Indiana Amendments :
FOUNDATION TYPE: (Check all that apply for the new
construction area)
I
o CRAWLSPACE 0 POST & BEAM ~PIER
o SLAB Q('BASEMENT (WALKOlIT:_Y vN)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences within ISO
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within IS months of the issuance date. pass I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC l2) 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, aU applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana -1993n (Z'
289) and amendments, adopted under authority of LC 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitc en, 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
Dcc cy has been i~~~d \Y th~epartmen~ of Community Servic~el, Indiana.
( ~ \ E-Ihll'\.{ ,\ lJjr.;bbih.'<:' 4-()~-O,
Signa re of Ow r 0 th zed Agen Print Date
I
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~ / / 5. 0 D _"\
~ 13<6,50./
.55,50
OFFICE USE ONLY: *******
Filing Fees:
Base Inspections:
Cert, of Occupancy:
INSPECTIONS REQUIRED:
Upper Footi ng
~
Lower Footing
Meter Base
Under Slab
~y
'/--Zl-
(Date)
# Charged Re-
Reviews
Additional Fees