HomeMy WebLinkAbout07050027 Application
City of Carmel/Clay Township Permit #D7D5(){)27
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
\<N~lA82.-- PHONE:~\1-_111-_1-L\40
STREET ADDRESS1,C00 \Y'\:(, J I A:0 \-h lIs l.A~i.
BUILDER'SEM~A~Ks@'KGR.lAW. CDM
NAME:.:JAf"/'\e.S' ::(q KNAUU2..- PHONE311r d~t-~~I.}O F31
STREETADDRE~ fv'\e\2.\~~ HdLs ~:s --.rAd
t';; # II ~\~~Nct~\ (JLlb
OF CONSTRUCTION \Cj d-I-\ ~ ' \ \ D ~ ~t- ~ ~ d Is
NAME:~
BUILDER
OF
RECORD:
~d is
FAX:
'SM"\f2.--
ZIP:
Io"d-L{-tl
STATE:;-0
BEST METHOD OF CONTACT: ~\\6t-JS
PROPERTY
OWNER:
STATE: ~
-~1- - :}130
ZIP 46 -yf (J
LOCATION
&. PROJECT
INFO:
ZONING:
SQUARE
FOOTAGE:
SEWER UTIUTY
PROVIDER:
WATER UTIliTY
PROVIDER:
ESTIMATED COST OF cON~U919~_:.___ -:"'= :~, I
(EXClUDING.LANDV~ALUE)_.;-c', r. ,\ f; \"'2:~: ',--, \ '
t~_ ,..--" ,.,......." \~----; 1\ ':;, --' \\ \',[
-'\ ,,- \'-" ,.- . co -,
1 \ J ~_:~ :~ ::-- ~-
'IL), \
'r/,x"MAP PARI\\''' l - 4. 200
ill III
.11 1....\1
PLUMBING CON'TRACTOR:-
\
NAME OF UTILllY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WEll AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
flOOD ZONE AREA DESIGNATION{S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
)0( SINGLE FAMILY oaEW ~RE
o TOWN HOME .Q IbrrION(S)
o TWO FAMILY p, CoN~ !,~\\~ON(S)
# of unjl:l;..~iJlij) fO. "'llO\\ tiE'ti< AOOITION(S)
c_'al!tt'a'f~?\lance a\CQO~"'O S
ti~~CllO c and Lac inish only
o RESIOt:NTIAL(If~ale ~ MUN\1Jf ILDING
AdditiOns.~~iEMI I CIfP-.'{D ED GARAGE _I
OE CF>-'r\MC\... ;'SL ATTACHED GARAGE {P( {'
PROJE~~ATION:\NO\N~ DEM+UTION J I"'-oh ":,
Early Rei Base Manufactured .0 ~ ( <; \~ I \)
Permit: _Y _N Trusses: _Y _N
Lot Split: _Y _N Sump Pump: _Y _N
Plumber's Indiana State license #:
o International Residential de wI Indiana Amendments
o Uniform Plumbing Code wi Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
~ CRAWLSPACE 0 POST & BEAM _PIER
o SLAB 0 BASEMENT (WALKOUT:_Y_N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is valid only if construction commence's within 180
days of the date of issuance of the building pennit, and must be completed (Certificate 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 alterarion 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 Carmel Indiana - 1993n (Z~
289) and amendments, adopted under authority of l.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 floo drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Oc 'P cyhasbeen, ytheDepartmentoICommurutYSecvi.::J~e~ianaKNP<.Ll~ 5~
gnature 0 wner or Authorized ~gent Print Date
o
EONLY:******************************~~****************************~***************
INSPECTIONS REQUIRED: FIling Fees: / 6- 'if ,
. . Base Inspections: 7 'l~O # Charged Re-
Upper Footmg Lower Footmg Under Sla ReViews
Cert. of Occupancy:
Rough In
Meter Base
Final
Reviewed/A proved: Dept. of Community Services
, S:Permlls/fonTI LP RESIDErfT1Al
P.R.I.F.: Additional Fees
oo~~~~ /10- (JO
Fee Received by: Date