HomeMy WebLinkAbout07040203 Application
City of Carmel! Clay Township Permit #: C) 7 D 'IO}.; 03
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
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BUILDER NAME: &l-lJ te; PHONE: FAX:
OF C(l!~ ~II.-bqzs-,Tk, 3/1' >"fS'-1Dt'{J> 317- S''1S' - lib!
RECORD: STREET ADDRESS: .:tl!oo CITY: STATE: ZIP:
~38'3 C.eAI4 <9r, -:r.J~ AwAPOLK rrJ ih-Z5I>
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
O<;j\1.~"w- 6 tlV,,~Ivtd>u;{d.4<;',C-OI"'" 5 to-I/ (v/<><;hw ~b II 311,7''f-S7ez..
PROPERTY NAME: 1\1 o~o,J 1V14',.l, J.,-k/ PHONE: FAX:
OWNER: ~ <;ilW\L..
STREET ADDRESS: CITY: STATE: ZIP:
S:d.I>\€..-
LOCATION LOT#: SUBDIVISION NAME: SECTION: ZONING: -Puh
& PROJECT It.. 1) MO~": MAl,.)
INFO: ADDRESS OF CONSTRUCTION: SQUARE J 7 jp 1/1
33 Fl,.o/2-l;~ 9r. t4tz.r...-e'L.-, r,.1 t.l-b 'Z 32.. FOOTAGE:
SEWER UTIlITY WATER UTILITY I ESTIMATED COST OF CONSTRUcnON: ,
PROVIDER: ~L.- PROVIDER: CAf2.M.:ev (EXCLUDING LAND VALUE) (; 12.0 DOO
I
NAME OF UTIlITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET .Il1~ li\(UlI/"'H-tf Pv 1> ~."G DOLkl.:tl:
NUMBERS; TAC DATE(S); AND/DR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE)' bp (A,...DS ~ 0 Ll-OI DO 31A o 'folo 0 35'2-
FLOOD ZONE AREA DESIGNATION(S) " X '~/\6h?~ .... TAX MAP PARCEL #: (b-ctf-Z']-O"2.-05 ...D2<,. cot
FOR THIS PROPERTY: '"/;l)N6 o 7 DlfolltJ if.-oq-2>-D'2-'D3-o~{. 00
TYPE OF CONSTRUCTION:
,g...SINGLE FAMILY
--ll:.l. 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:
_VkN
_V~
o
TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
JI:[ NEW STRUCTURE (l-.~ t2. fl,NMBt41
o ROOM ADDIT~) Plumber's Indiana State License #:
o PORCH ADD !J !::
o DECK ADDITIO ' Ot l S$D f: D P ~&'~ 0 0 I:>
o REM~~sE~. . '5_tfJ6~CO""'/)I..~h1ttjlumblng codes will be applied to the construction:
o ACCESS I~~~te C/ _il~fl{iili"Jlal Residential Code wI Indiana Amendments
o DETACHED A~ Co :!)1f-6 "!th /'fI1~ ,
o ATTACHED GARAGI!""'li">. 1'I1tl1rI:q,,!ljfdril(l!!~u'Jflloii\lt5;ode w/Ind,ana Amendments
o DEMOLITION . . '1'4t~ f..t.~c.~'9lJ/f.tlb..'!!
IN, "I.. / C N I~ (Check all that apply for the new
Manufactured V ~/..i A, fP"ll J;'~~9lie.
Trusses: ::::!!...-V _N 'V...q ~~~~:"CE 0 POST&_BEAM_PIER
Sump Pump: _V XN g SLAB'/j/~ BASEMENT (WALKOlJT:_V_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 IAC 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 - 1993" (Z~
289) and amendments, adopted under authority of I.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kItchen, bath~floor drams are connected to the samtary sewer I further certIfy that the constructIOn Will not be used or occupIed until a Certificate of
Occupancy as en r sued by the De artrnen70f Commumty Semces, Cannel, Indiana ., J _ z I _ .......
&0. (c4-- 4w(( Ill. Ml),;'W- ~
Signature of Owner or u oozed Agent pnnt Date
OFFICE USE ONLY: ************* *** **** * ******* * * ******* ** ******************************************
F'I' F . f~() f~ n
INSPECTIONS REQUIRED: ling ees. :. 1 --' '{j-
=-=-- . Base Inspections: 2'E f'j. 60
Upper Footing Lower Footing nder Slab -55 51)
f."," "'< Cert. of Occupancy: .
Rough I \!"'-!,ter Ba~ Pd.; cL
W~ ~ P.R.I.F.:
ReViewed/Approved: Dept. of Community Services (Date)
S:Permits/FormsjILP RESIDENTIAL
# Charged Re.
ReVIews
Additional Fees