HomeMy WebLinkAbout07050021 Application
City of Carmell Clay Township Permit #: ()? 05()O;Z)
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:
SEWER lfTIUTY
PROVIDER:
NAME:
~~T(l\\~c G..J>""J'"QJV\
STREET ADDRESS:
/4 k.o LLAY lE(ll/J<<.C. C!.'-vt>
BUILDER'S EMAIL ADDRESS:
~I'@ ~.(~-Il~.:\
NAME:
j; 110 2.uo
.:J>l\+l: ~^IZlS"'M ~""-"T'
PHONE:
FAX:
Bl5-ZS11.-.
ADDRESS OF CONSTRucnON:
I "3 ::I 1- '8 el, "-l'-.;N tho""""\) ST.
i.~ 9-8 ~Jo
CITY:
ZIP;
1Co>z-
STATE:
/.,)
~
BEST METHOD OF CONTACT:
e."""'-i\
PHONE: FAX:
111"'- 9\""1- -:1'1'1"-. ., "/A,',
..:.;..\ -', '''>.\,"":::':''\ 1!~/:-',"~ .".,.,~,. ;S:QT~I..."U.
CITY: , ~'. .. ,.'~f~~~ ,jv.s+;:rey,.:""-'~~--.i,"/A1.ztp:'.df~/':,,,
\ &"i';"';t::t? q~rliP!.1ance \'~lJ1.,r~:,) r~~'Djdll '~J'1-
I ~'':r''o,~..-~,<;...;. .,..i.,....... "!I.'I"I...r'~',I"
-, ~~ ,-,,,..,,, .... '-'.. . " . '" '>t .
. __~,~p1' m~~r'fi.i~'u~':~.r'~~~:~~~f~b;~9'~
-:: ~,".....'. ,].--1 ,/ ."'" r'd ,: .,,,..,,rdtZ'UJm
..111 ur '-'hI ""'.'~' ',....... .., '
-- - , .,' SQUARE
INDiAN! FOOTAGE: & 88i3
I ESTIMATED COST OF CONSTRUmON: j A(
(EXCLUDING LAND VALUE) .,. ., (", I.. 0<>
STREET ADDRESS:
j"1.e.z.o J...,.fIEru.<"'( ~,J\ ",pr "J.D
LOT #: / j SUBDIVISION N~E: 'I; II<l8e of
"T '1l\jbl- t.-'€ J<r C,-", ."
Ci-A.'(
WATER lITlUTY
PROVIDER; <::...Ar...Ml.!1...
{LT }.AA,u~. ,::It CJil (JjO{f).D
I TAX MAP PARCEL=#.'I rs 0' is;' I'] \\ ri ;;.'.: I" ,...'
: II' \ I ~ ~,::,:7 l~J '- '':1/ t :; , \'.
I; ) I r--,--_u_--~-;;=<-I I ~ l'
NAME OF UTIUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (iF APPlICABLE):
FLOOD lONE AREA DESIGNAT1~.N((SS}
FOR THIS PROPERTY: -TAW
-
TYPE OF CONSTRUCTION:
.d!;(" SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_Y /N
_y....LN
'^ - wlSi-uuleA
TYPE OF IMPROVEMENT:
~ NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
Sump Pump:
./ Y _N
LY_N
! 11_'.1 I
PLUMBING CONTRAqO~:
~ M-<>"Jil III MAY - 4 2007
Plumber's Indiana State' License #:
I '
10051....0
Which plumbing codes whr6e applieCfttfthe'constnJction:
~ International Residential Code w/Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
III ill
ill iili
1[9
I
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & _ BEAM _PIER
o SLAB ;rs; BASEMENT (WALKOUT:_Y ./ N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is valid only:if construction commences within ISO
days of the date of issuance of the building pennie, and must be completed (Certificate of Occupancy issued) within IS months of the issuance date. Class I
struCture pennies 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 LC. 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
o~asa=bytheDep"'tmentofCOmmUnitYSecviCe',~da..J t/'!.I 'f 5l~~~
Signature of OWner or Authorized Agent Print Date I t
OFFICE USE ONLY: ******* ** **** ** ************************* *************-************ ************* ***
INSPE S REQUIRED" Filing Fees: /0 %<. 9'cJ
" Base Inspections: c2?7 ') ()
Under Slab
Cert. of Occupancy: S5' 0')0
P,R.I.F.: / J (;1 () () Additional Fees
( ~..1t::,b
FeeRece~ ~ Date
Revie
I
Si
5-/0-07
(Date)
# Charged Re-
Reviews