HomeMy WebLinkAbout07050089 Application
City of Carmel/Clay Township Permit #: 61D6eo't!!
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
-R1 \ t e \mrM:S
PHONE:
'-) -lS - d- 350 -\ ,Y\ y
FAX:
561-ll( .::r-
STATE:
\
CITY:
iF5,<'c) (V M.Q ~
BUILDER'S EMAIL ADDRESS:
\ v0.ev, \(." iLh lui\u \ -\ 0" U_"YV'-..J
NAME:
::::u </'I'J2 0.::, CL\.:)l
SUBDIVISION NAME:
c-'VViV",--\ (v-l" 1< E~+z'L'+C::,
iDRE~ ~ CONSTRU~ON: '.J
~<- 'J I ,c"- \ ""\0', <Drl v~
SEWER lJTILITY,r, . l WATER lJTILITYr. . .
PROVIDER: U' ~ \'Y\e PROVIDER: ~p V iV\ c I
NAME OF VTlUTY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
PLUMBING CONTRACTOR:
QV\tWl iYVj' Iv {V
P 'umber's Indiana Stat
(-, P 101'. (:'II) {(..0 'b ~
- I.L l. .::51..,- J: ~
Which plumbing Cod~QllQ aoPI~'~e construction:
~; ~__~,., ~ " I)-,
~ntema~~""~e~al'l:oAe'w IIndiana Amendments
o un:~~~~Jt~~~~diana Amendments
FOUND p ~ <?r\eck all that apply for the new
constru. . OQ r ) Cl) '0
Early Release Manufactured , !I./ 0
Permit: _Y $N Trusses: AY _N o's?? ~AtE 0 POST&_BEAM_PIER
Lot Split: _Y -->> Sump Pump: ~Y _N i2::~ .pI.cfJ3V fit BASEMENT (WALKOUT:_yXN)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory s :u~ this ~ valid only if construction commences within 180
days of the date of issuance of the building permit, and must be completed (Certuica o~cup~...t~d) within 18 months of the issuance date. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 67~\QJJ 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 strucrures
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 - 1993~ (z-
289) and amendments, adopted under authority of r.C 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I [unher 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
OCCUpaIJcy as ~en issued by the Department of Community Services, Cannel, Indiana.
, , <(JC'f~ ('VldC\..., Kdci',-- 5/ /t.)/fJ7
.
PROPERTY
OWNER:
STREET ADDRESS:
LOCATION
& PROJECT
INFO:
LOT #:
\ 0\ Lv
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
''Q'- SINGLE FAMILY
-tJ-TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Signature of Owner or Authorized Agent
x
~
BEST METHOD OF CONTACT:
--Q...~
PHONE:
FAX:
TYPE OF IMPROVEMEW
~NEW STRUCTURE
i']'ROOM ADDITION(.
o PORCH ADDITION(.
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
Print
CITY:
STATE:
ZIP:
SECTION:
ZONING:
r"
2)--
SQUARE L:. V"
FOOTAGE: V-J Ll 7
ESTIMATED COST OF CONSTRU~DN:I V /7 I..-'/)
(EXCLUDING LAND VALUE) $ 0 c i;) C ___
yf. , ;;'Y;:i'''; I
:: X(_r.,:'l,n~ 1'1 {l
~
..., ... ~L'~
. "" ..,J
- ( (, 0..,,' -,t!'
TAX MAP ptRCEL #:
ft. 3 sli de:, 5~O CDC.
v
2f:.<-X) )(.0 i I (Ct I
Date
OFFICE USE ONLY: ******* ***************** ************************** * ** }1**p *!**********************
INSPECTIONS REQUIRED: Fiiing Fees: . .V?~ c ~o
~ ~ B I ct CJ 7,- #ChargedRe-
Upper Faa -' g ower Faa - g Under Slab ase nspe Ions: r; ReViews
Cert_ of Occupancy: S .' )0
("&n-'~'~ ' 'P.'.I... /-2. of. 00 -,-
~ .. . ;L-'>?--J'Y2 :;'0
Reviewed/Approved: Dept. of Community Services (Date)
S;Permits/Forms/ILP RESIDENTIAL
Fee Received by:
Date