HomeMy WebLinkAbout07050090 Application
City of Carmel/Clay Township Permit #:o7050oCfO
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, S. Two Family: New Structures, Additions, Remodels, S. Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
s. PROJECT
INFO:
PHONE: " luO
;311),,/f
FAX:
NAME: J/-e;/;
STREET ADDRESS: / I
'74..,
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
;),&7 5
STATE:
Af./w fa/~shne.,
{N'
ZIP:
t.j (01 (03
CITY:
Cf-.
J"
'.r J BEST METHOD OF CONTACT: J
~oo.c:.i)"",- nOVIe...-
PHONE, / ~ ~ FAX:
(JJ~f'J.i4.g~~if! 1\
CITY: C ~. .....r >fATE/./ ZIP:
Rt:.~.~,(~ FOR cONsrR'DcTlo~ (p 0:3
BUILDER'S EMS A'li~~ Ii {'-I d L/ (0
NAME Pl-J~ H~I /:nd
6e/w1clG ~e.-
SUBDIVISION NAME: SUbJ'GCt-t0 cCSe:::rhJNlCG with a: ~tions
Vii/a v {We5+- C/<l({tatH a;~(! Locai Cedes. \
12 . L DEF'T 0.:: COMMUNiTY ~I.I.\CE't 07
vefLJ,()( A;wrc)F~bf:tJ~(f(dJ!'(, .~IilP.1 .
STREET ADDRESS:
/333?
LOT #: ::t
i '3.J
ADDRESS OF CONSTRUCTION: I -i -v
./~3J
TYPE OF IMPROVEMENT:
SEWER UTILITY . WATER lJTIUTY /' J~ I
PROVIDER: CIa PROVIDER: L--t2rmel vi!~
NAME OF UTIlITY VATION CONTRA OR; PLAN COMMISSlON I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
~ RESIDENTIAL (For
Additions, Remodels, Etc,l
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o DECK ADDITION(S)
o REMODEL
-1 Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
PROJECT INFORMATION: 0 DEMOUTION
Early Release ~/:'. ~ Manufactured _y__-~.-:: /
Permit: Y V T~~sses:,~/
Lot Split: Y i/III Sump Pump:
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction conunences witNn ISO
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, reconstrucrion, enlargement, reJocation, 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 Carmel Indiana -1993" (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 floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occup;mcyhas been issued by the Departmen f C unity Services, Carmel, Indiana.
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Print \
,
*~il********r**********************~**************************
) 17 - (;Fjling Fees: / '39- .:rO
INSPECTIONS REQU' (, / ' ./
V I ct l/ '- () 0 # Charged Re.
L F t. U d SI b ' ase nspe ions: / , >
ower 00 mg n er a I .-...- / ReViews
~nal= _.../ Cert.ofOccupancy: 50, ,<., 0
Meter Base ~./
P.R.I.F,: Additional Fees
w;J;~~ci:O
"
i);
I:
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v
Which plumbing codes will be applied to the construction:
o International Residential Code w/Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
_Y_III
FOUNDATION TYPE: (Check all that apply for the new
construction area)
.:RJ CRAWLSPACE 0 POST & BEAM PIER
o SLAB ~. BASEMEIIIT (WALKOUT:_YA-III )
5/1/07
Signature of qwner or Authorized Agent
OFFICE USE ONLY, ***********
Oate
y-! g~()1
(Date)
e . of Community Services
IDENTIAL
Fee Received by:
Date