HomeMy WebLinkAbout07050175 Application
City of Carmel/Clay Township Permit #: 070<;!)/7S-
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &: Two Family: New Structures, Additions, Remodels, &: Accessory Structures
BUILDER of
RECORD:
BUILDER'S EMAIL ADDRESS
LO Ie f <9>h Orr, ~
PROPERTY
OWNER:
NAME
L
FAX
STREET ADDRESS
':1.
em
SlATE
ZIP
LOCATION
&: PROJECT
INFO:
- .
ZONING:
ADDRESS OF CONSTRUCTION
3 'e." +
SEWER vmm (b,. /T\e I "70<">" S4,p WATER vnUTY /", -/-r,!J;;'r,
PROVIDER:j{c; ',P"...' Wa..s/C. b.s ~ PROVIDER: r~'rffie - .,ILII' ,
SQUARE
FOOTAGE:
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE{S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
n
TYPE OF CONSTRUCTION:
lSti. SINGLE FAMILY
D TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc,)
TYPE OF IMPROVEMENT:
~ NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
PLUMBING CONTRACTOR:
J-kuY\ 1"'"'1 "'-n,d S{:.(\s
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
o International Residential Code w jIndiana Amendments
o Uniform Ptumbing Code wi Indiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release
Permit:
Manufactured FOUNDATION TYPE: (Check all tha~ply for the new
-' J(, "-'- -' ;(, ~_.,,"'~) i:l~~\~ ~'b
\/ 'V . 0 CRAWLSPACE 0 M
Lot Split: _Y.LI..-N Sump Pump: AY _N 0 SLAB ~ ENT ~Cb
Does any part of the property lie within a special Flood designation area: _yeP ~'S' ~ ,0 ~ N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structurcs,;_~ er~ \...~~ i ction commences
within 180 days of the date of issuance of the building permit, and must be comp]et~d (Ce ~~&tc~~'iff~~~~ in 18 months of the
issuance date. Class I structure permits ate subject to the Genetul Administrative Rules \~s,,'5t~r'll"\\~~'t?J~C \2. )..regarding expiration
time frames for beginning and camplet O~C",\dit. O~'~\ !'-
I, the undersigned, agree ~hat any co.nstru.ction, recon~truc[ion, enlargement, relo~atlon, or ~~ion Or~;.T1ga~ g~;.i-r'the ~se of land or
structures requested by thiS applicatIon will comply WIth, and conform to, all applicable laws of the~AAeQV~~a, _ e "Zo~tli'ig Ordmance of Carmel
Indiana - 1993" (2- 289) and amendments, adopted under authonty of LC. 36'7 ct scq. General A~~ly~'Ktate of ndlana, and all Acts amendatory
thereto. I funher cenify that onIy kitchen, bath, and floor drains are connected to the sanitary se\V~Mther certify that the construction will not be
used or upled unul a ertd;c te Occupancy has heen lssue~the Dep,"tmenr or Co~,ty Servrces, Carmel, Ind,"na
C /I-c'~ /11 c I tf./A~//,~ ,<;/ I ~/()7
Print J ~
OFFICE USE ONLY: *********************************************~*~***********************
Filing Fees: t'/ '/3 , .s <5
INSPECTIONS ~QUIRED: . -, 0 '7. ~(]
Base Inspections: ~ 0- .4 ,2...L
nder Slab c--~, -/0'
Cert of Occvpancy: ,2... J ~
p, R, I.F,: / ,) (;, /. d 0 Additional Fees
_' ,.,~' TOTL' ~]36
C' .'{'1L. q HI~ ~. ,./3-07 .~ f 'j - ,
Reviewed/Approve&: Dept. of Community Services (Date) . ~
S:Pennits/Forms/!LP RESIDENTIAL Fee Received by: V
# Charged Re-
Reviews
Si