HomeMy WebLinkAbout07040162 Application
City of Carmel/Clay Township Permit #: 0 70L101.k2~
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:
NAME:inc (2S16 (Z. aJJc;T[tU(.,ltor- PHONE
STREET ADDRESS: ~? f. P/~ B e- Dti.
BUILDER'S
Ile";.ESS v-le ;nJsi
NAME J AWte;<; t\..~t:-
STREETAD7~91D AVICIS p~
CITY:
CA.12.wt e-L.
SUBDIVISION NAME: , I "A /' ,^.;~CTIoN: '$ 'Z. 2. ZONING:
V ILL- e OF trIt. ~61. -;) '5 'r....
ADDRESSOFCONSTRUCTI~'110 ADIl)4 p~s CMl.Met;,~IH;: ~g~~~E 4U~
r~~~~~Gc3JJD~AE~~)SrRUGn~:'4 "'b-(je~
Jlr_ \ I .., ;..'
illl I'i I APR 2 3 2007 'i i IIi
I ~ Ll! / ,I i I j
TAX MAp PARCEL #: ---_J [~jl'
L_
PLUMBING CONTRACTOR: ---------_.J
'Do ese- ~ II\J
Plumber's Indiana State License #:
c.P /'94060 7q
lOT#:
Z.4~
SEWER lfTILITY
PROVIDER:
-1'54D
4b07
t51c..f-1t./O J
uJe:s-rFII:n.oTE I t-J
FAX:
STATE.: \
IIV.
t.J(;o~Z
f
NAME OF UTILITY EXCAV ON NTRACfOR; PLAN COMMISSION / 6ZA / 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:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
~ RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_y.r N
_Y/N
TYPE OF IMPROVEMENT:
NEW STRUCTURE
ROOM ADDITION(S)
PORCH ADDITION(S)
DECK ADDITION(S)
REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
o
g
o
o
Manufactured
Trusses:
Sump Pump:
-0_N
~Y_N
Which plumbing codes will be applied to the construction:
o International Residential Code wI Indiana Amendments
p Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
~ CRAWLSPACE
o SLAB
o POST &
BEAM
PIER
o 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 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 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 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 c ected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Dee" ancyhas eenissu e epartme tOfCOmmUnitYSeMt;~/7H~:1.. J. fOE;ehTd .A J~/07
Print ~ '
OFFICEUSEONLY:******************************~~***********************~**** *******************
INSPECTIONS REQUIRED: FIling Fees: . ~
Base Inspections: ::)0
Cert, of Occupancy:
# Charged Re-
Reviews
Under Slab
3
Meter Base
Lower Footing
P,R.I.F,:
j 1/ 0,
Additional Fees
i~
TOTAL:
Fee Received by:
Date