HomeMy WebLinkAbout07040207 Application
City of Carmel/Clay Township Permit #: 070 if 02fJ 7
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:
SEWER UTIUlY
PROVIDER:
NAME: PHONE:
'B;Z-1.l{E' ti\)~~ f>.>1L--~ ~t. ..?17-"5'qs-~Ofts
FAX:
311,~5- 2-11<>/
STREET ADDRESS:
3Yi3
t(l.AlC{ 4'r. V 00
CITY:
T""~IA.""l\f",u~
ZIP:
4bZS-o
STATE:
Tr'
BEST METHOD OF CONTACT:
<(. ~Iuv all 317-7/-1- O!>2-
BUILDER'S EMAIl ApDRESS:
tv) o>r./W t
NAME:
. ':'0 ""-
PHONE:
~"'~
FAX:
fV\o~.-I '\ MAl,.) I /..-Ire..
STREET ADDRESS:
.:; ,,,,,,. e-
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
lOT #:
111:>
CITY:
STATE:
ZIP:
SUBDIVISION NAME;
/I'lO,:lD.oJ 1
SECTION:
ZONING:
Po)),
I, 7Y:> ~
tvt4,(,..I
ADDRESS OF CONSTRUCTION;
/{o ~l,ol2i?t.>c.::; 9['.
CA~L. r"'>
LtbV2...
SQUARE
FOOTAGE:
CA~~ L.-
WATER UTlUTY
PROVIDER:
C.A .u.18--
ESTIMATED COST OF CONSTRUcnON: J
(EXCLUDING LAND VALUE) If' ('20 l> 00
(
IJllAh elCt'lV""T'L'>4 p~!> (/..E'ZD'~ jte"'"
M At, J; I> 0'00>) O'to{ o",;'~2.-
TAX MAP PARCEL #: i~- dj - '25" -D~-Q?- '''IN. 0.0
tJ7olfoZ II- -~- 2S 4>2 -uj'-"'Zl.'"
PLUMBING CONTRACTOR:
(2.1 ((. PI"...t;,;",V
Plumber's Indiana State License #:
tP&>'~Ol>\5S-
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):
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
g TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
Early Release
Permit:
PROJECT INFORMATION:
Lot Split:
_Y~N
_Y~N
b-o~B "')G'~ vVW5
TYPE OF IMPROVEMENT:
~ NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDITION(S)
o sREMOBDEL F' . h I Which plumbing codes will be applied to the construction:
asement InIS on y
o ~UILDING ~ International Residential Code wI Indiana Amendments
~ A~~f1rt:o~~ CO^ 0 Unifonn Plumbing Code wi Indiana Amendments
c1)~o~~~~e ISTRu
" ,,.., 0" 0 !:1fJCI L 'WIth a// ...CilJnlaAnoN TYPE: (Check all that apply for the new
tiI;r.y,~" C~,. OCe/ C rS~on area)
a (,.v/(;^" OCle ~~"tr/On...,
Trusses: Fl. 'I r't'l/y s€ s. LJ CRAWLSPACE 0 POST & BEAM _PIER
Sump Pump: 1No~~l:!A. y 7"0 AV1C12. . SLAB 0 BASEMENT (WALKOUT:_Y_N)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structure, pennit 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 Carmel Indiana - 1993H (Z-
289) and amendments, adopted under authority of I.C 36-7 et seq, Genera] 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
Oeeupaneyh", issued h the Def""";[ 01 :ommUnity Seme",. Cannel. Indiana.
/(), . M. <7lo1T M. MO:;~ L1:IZ~/'l
Signature of or Authorized Agent Print Date
OFFICE USE ONLY: ************* ************** * **************** ************* ***** *** ****************
NSPECnONS REQUIRED' Filing Fees: 5'8 () p &> ()
.., Base Inspections: :;z ~ 7. 5-0
Lower Footing Under Slab
Cert. of Occupancy: 55'", SD
7/3;c{ '1 f.V';OU1i j,
# Charged Re-
Reviews
Site
P.R.I.F.:
Additional Fees
/
Reviewed/Approved: Dep. of Community
S:Permits/FormS/IlP RESIDENTIAL
(Date)