HomeMy WebLinkAbout07050141 Application
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
I
City of Carmel/Clay Township Permit #: 070 S-p011
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory StrJctures
ES
ME..R.ID/At-l ST
PHONE;
575-d2J50 ;( dQ0
CITY;
f2Jvi.&L
FAX;
5; /-77Q2.
ZIP:
4003b
STREET ADDRESS:
5'10 N
BUIU>ER'S EMAIL ADDRESS:..n f) BEST METHOD OF CQNTAG:
'.ANNE" ..sttEPHEiW~ rLLLYE. tOm Elv/AIL
NAME:
Sfi<<I[
STREET ADDRESS:
LOT 4-5
STATE:
IN
PHONE:
FAX:
CITY:
ZIP:
STATE:
SECTION:
-.1-
ZONING; S _ .1
SQUARE 5.1:;- 15'
FOOTAGE: .0
J-J1\--,01 I/J A
FLOOD ZONE AREA DESIGNATION(S) " V t \
FOR THIS PROPERTY: f\
TYPE OF CONSTRUCTION:
~SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_yV-;;
-y-~
TYPE OF IMPROVEMENT:
~EW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
o Uniform Plumbing Code wjIndiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB ~BASEMENT (WALKOUT:_Y_1..1<f)
Manufactured
Trusses:
Sump Pump:
vy N
vY' N
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 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, 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 - 1993n (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 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 Cerancate of
Occupancy has been i ued by the Department of Community Services, Carmel, Indiana.
JQ4.N N f:. -S:H&P HE.J<JJ .s II S / Or;
'-.
o USEONLY:******************************~~******~*************s;'~~~****************
:~SPECTIO Filing Fees. -
,..-- ( Base Inspections: :.:; 8 ~ a # Charged Re-
'-UDDer F . ~ ReVIews
Cert. of Occupancy: J.5 SO
P.R.I.F.: ./r.&.I1~' b./. (){) Additional Fees
~~ 4jf?~JO
Fee Received bv. -;f:l;J.
c;:.;~
......
fA/;
Print
D.te
(Date)
Reviewed/Approved: Dept. of Community Services
Date
S;Permits/FormS/llP RESIDENTIAL