HomeMy WebLinkAbout07050136 Application
.. City of Carmel! Clay Township Permit #()1 /) 50! ~~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
NAME
PHONE
813-
FAX
$ 3 -:(775
ZIP
Jf003
BUILDER'S EMAIL ADDRESS
BEST METHOD OF CONTACT:
PROPERTY
OWNER:
NAME
3ft-A G
PHONE
FAX
STREET ADDRESS
CITY
STATE
ZIP
LOCATION
& PROJECT
INFO:
LOT #
ZONING:
5-/
t,J,5
SEWER lfTILITY
PROVIDER:
ADDRESS OF CONSTRUCTION
'fDO
tl/tt
SQUARE
FOOTAGE:
WATER UTILITY
PROVIDER:
ESTIMATED COST OF CONSTRUCTION'
(EXCLUDING LAND VALUE)
cO
.< t)/ () ()O .-
.,-."\
NAME OF UTIUTY EXCAVATION CONTRACTOR;'P':AI:',COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COu'fI;(wPi aND/OR SEPTIC PERMIT #'S (IF APPLICABLE)'
/. ,V?~\\ \\\
TYPE OF CONSTRU~~0~~1 ~
o SINGLE F~~ -V> ~ '(
o TOV'!.N+IQfj'lE~ 'I\'l~
o lV'{9;F.~~lIlY/ \ 'Q ~
#of'un( . ~
o MULN:fA Y ~ '
# of ~llltS
S-- RESIDEN h: or
Additions>' mo els, Et .~
Nit
Manufactured FOUNDATION TYPE: (Check all that apply for the new
V \I' construction area)
_Y ~N Trusses: _Y ~N
o CRAWLSPACE
Lot Split: _Y LN Sump Pump: _Y LN ~ SLAB
Does any part of the property lie within a special Flood designation area: _ Y -2S.....N
Early Release
Permit:
o
o
POST & BEAM
BASEMENT
WALKOUT:_ Y--XN
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences
within 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits 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 alceration of a stnlCture, or any change in [he use of land or
structures requested by this application \\.ill comply \virh, and conform to, all applicable laws of the State of Indiana, and the ~Zoning Ordinance of Carmel
Indiana - 1993" (Z~ 289) and amendments, adop~ed under authority of I.C. 36-7 et scq, General Assembly of the State of Indiana. and all Acts amendatory
thereto. I further certify that only kitchen, bath, and floor drains arc connected to the sanitary sewer. I further certify that the construction v.rill not be
used or occupIed until a Cernficate DE Occupancy has been lssued by the Department of Community ServIces, Carmel, Indiana
~ L~ ~"r-N-rR(/>tS~ C'-YAJlJ ACh-r,e!l)C5~I&Jt27
Signatu.J:;~":'er or Authorized Agent Print r Dan;! / .
OFFICE USE ONLY: ************************************************************************
Filing Fees: ;..l I :3 'a,O
NSPECTlONS REQUIRED: . I 7.'''''
Base Inspections: ~ _0. # Charged Re-
Lower Footing r Slab r.::: ~ .' c="o ReViews
.-= Cert. of Occupancy: -"~ 'J
Site
ough 1
'"
wd( t4tf,
Reviewed/Approved: Dept. of Community Services
S:PermitsfForms/IlP RESIDENTIAL
Meter Base
Final
Additfonal Fees
P.R.I.F.:
(Date)
TOTAL: ~.50
r------
Fee Received by: