HomeMy WebLinkAbout07050112 Application
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City of Carmel/Clay Township Permit #: 8705(')/1 d.,
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
NAME:
, STREET A~SS: "
. \{. \{'{iSm \-If.
PROPERTY
OWNER:
NAME:
STREET ADDRESS:
PHONE' a.3 "7- 130D FAXji7. ?:j.f7-7~ig
j)1I~ STATE:'I W zElLP 21 <6
PhtJ"-L
BEST METHOD OF CONTACT:
PHONE:
FAX:
CITY:
STATE:
ZIP:
LOCATION
& PROJECT
INFO:
LO #:
4
SUBDIVISION NAME:V
ADDRESS pF CONSTRUCTl,ON ~ _
_J t (t'ef"lkdTr(i.'
SEWER lJT1UTY r'l, rl'. / n
PROVIDER: 1...JA\ II\.lX...
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
o fiINGLE FAMILY r;z( NEW STRUCTURE
rI/ TOWN HOME 0 ROOM AOOIT~Q.~(S)
o TWO FAMILY 0 PORCH ~~x:fjQN(S)
# of units being . 0 O!;.C!<:4PDIT.:!l'1!ll<S)
constructed at thIs a::;~fMQH~J.).'~W"
time: <<at\. ~ ..-,,);l.'Base,l!1ent Fi"i.~onIY
o RESIDENTIAL (For ~:o,' .,~P "Ag:~SSO~Y,-l!UI~bI ~
Additions. Re'P'l~~rq)\i'~;' ',P..cDETA~Ij.!'O\G~~qjl.-'\
?-"\::.":aC~ \0 Cc>o>'" E''- 0\ 'AtTACHED,GARA'liE
10\"" ,'~, r' '\" . -
PROJECT INFO~ATION'} -, COhO 'D~9LITION
r( f 'I.'F\J -I>.
Early Release ....? {"1'-'r\JlIIaf\'!f~~;ea /
Permit: v v Tr\iSS'es: ~y _y
Lot Split: C'\ _N Sump Pump: _Y 2N
ltv
3~
ESTIMATED COST OF CONSTRUCTION:';::: ''10'"
(EXCLUDING lAND VALUE) If" l- !L CDO
SECTlON:
ZONING:
SQUARE
FOOTAGE:
Ct5MrllL-tl
PLUMBING CONTRACTOR:
Y~L l2: S.ffi\-rH
Plumber's Indiana State License #:
1011,'"1
Wh~ plumbing codes will be applied to the construction:
~ International Residential Code w/lndiana Arnendrr-ents
o Uniform Plumbing Code wi Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM ~PIER
~~LAB 0, BASEMENT (WALKOUT:~Y---,--N )
',.' .--;1 "
". :II \,1
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is vaJ,id o.Jjly, if construction commences wit,Nn 18.9
days of the da:e of issu~ce of the building permit: and ~ust be completed (certifi~ate of Occupancy issued) wi"~~~l~ .mo~ths of the is~uanF~,,~a~e. f.l~s;I: \
structure permIts are subject to the General Admimstratlve Rules of the State of IndIana (See 675 lAC 12) regarding ex, plratl()~ t.iIhe 4~s fOr\&gmnmgand\
completing construction. 1\ \ \ \ \ \, \ 1111 \ t::...'.J
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or a.ny, c~~ryge in the use of 1_~}2..cLor structures \
requested by this application will comply with, and confonn to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of CatTilel Indiana - I993~ (Z- j
289) and amendments, adOPt~er authOrIty of I C 36-7 et seq, General Assembly of the State of IndIana, and all Acts ~mendatory thereto I further cernfY.Jhat only
kitchen, bath, and floor dram are onnected to the samtary sewer I further cernfy that the constructIon will not be used or occupIed until a"Certificate of
Dc ancy at;t~d y ~Dcp~tmmtofcommurutysemces.carmmtil~<;tl G' I r'i~ 5 n J 67
signatu'" of Owne, 0' Au",o",'" Age . P,in' 5{2 Oa..
OFFICE USE ONLY: ******* ** ******************]l;*~~********* *******************!!.~********* * ******
ECTIONS REQUIRE . xl Filing Fees: 7 /9, '0 _
'"'1J,$sase Inspections: ~ g '7. 'J 0
Cert. of Occupancy: ....&)0. () 0
P.R.I.F.: \ /? (oA ~ 00
~2.!3:Z3.s()
Fee Received by:
60']
S:Permits/Form
prove ept. of Community Services
LP RESIDENTIAL
# Charged Re-
Reviews
Additional Fees
Date