HomeMy WebLinkAbout07040204 Application
City of Carmel/Clay Township Permit#: 0 7o'-{o 20tf
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 LfTILITY
PROVIDER:
NAME:
~~
PHONE:
tj\i~ .wla.-~,'~. 517-szt~
()t(S
FAX:
3/7 - s;q~ - ).{" J
STREET ADDRESS:
f3S3
c.(2A14 91. ;Jt(OO
CITY:
T<vb 1-t",AfOi-1 ~
ZIP:
Ifbz~o
STATE:
T,J
BUILDER'S EMAIL ADDRESS:
-fwt"d'Jv ~ Co .-.stv'lbv;[dl<'-5. Co""-
BEST METHOD OF CONTACT:
fI1"kw Cbl/ 3i'7-71<f-~78z....
NAME:
STREET ADDRESS:
LOT#:
lhC-
M o.r-lo"! ~ 1'1 'lIN, \...ol.6
PHONE:
FAX:
.f' et. "U...
CITY:
ZIP:
STATE:
nV"\.&
SUBDIVISION NAME: .
/I1ol-lo,J 5 hlA ,,0
ZONING:
Pub
SECTION:
ADDRESS OF CONSTRUCTION:
ifl ~l,o/2.."',:)t.e~.
CI4~~t..- ]:,J
'*'" 2.."3 2.
SQUARE
FOOTAGE:
&
(/NL~L.
FLOOD ZDNE AREA DESIGNATlDN(S)
FOR THIS PROPERTY:
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE):
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
;Iii( 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 X"N
y~
ESTIMATED COST OF CONSTRumON: A'I'" ~
(EXCLUDING LAND VALUE) or bV ( tl 0 0
Ivl~ t'''''o\VA'-'''4 Pub ~'20">"'- l>0{~
bp vb;; :t.o~oloo O'/'OIC03S'2.
TAX MAP PARCEL #: 1(.-oC{-U-oz,-o3 - Ou._ 0
o 040211 l(,-()'\-ZS--O~-O? -0;1.1_
TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
~ NEW STRUCTURE I)l$<: (21/2. P"".'\'\fl"'4
o ROOM ADDITION~1>' $,qS Plumber's Indiana State License #:
o PORCHADDITION(S~&Cl !Co "no,oc 13 r
o DECK ADDmo~ 0 '0 Co f:'0 lA"O ~ \'l D 0 ~
o REMODEL OIl> ,~.,o ..c. 'I' StQ>,~~~g codes will be applied to the construction:
_ Basememr"}fl ""'~" I)c
o ACCESSORY BUlL 00 a~t~ ~~u.idential Code wi Indiana Amend,,:,ents
o DETACHED GARAGE "II'1A. 'II",": ~I Q,",""-'~II>l>b/("Ihdp II d' A d ts
o ATTACHED GARAGE 'T'vl,s;@l7<.iJl.\~~~'u_ -y,rI!l_1{J;; w n lana men men
o DEMOLmON /, <: /.. '/"/'1; O'O.l> 1.It.?1' ~ ,
/VDI. FOiWtDA~N TYPl9,1)"Check all that apply for the.new
Manufactured \ , ~.CJ'Jf j{~ ~k_
Trusses: ~Y --'.N 0 ~~ 0 POST&_BEAM~PIER
Sump Pump: _Y 2(:::'N ~ SLAB ~ASEMENT (WALKOUT:_Y_N)
WATER LfTIUTY
PROVIDER:
o A-fl.l'1I?L.-
1A>,.)E-
" 'x: ';. "",,~\I.
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences within ISO
days of the date of issuance of the building pennit. and must be completed (Certificate of Occupancy issued) within IS months of the issuance date. Class I
structure permits 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 structur~s
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 amendment dopted 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, an oar ins are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupancy has en is ueby the De:ar~t ommunity Smices. c~;~anaM., M.ob ~ 4::/ tt("7
Signature of Own or th Agent Print Date
OFFICE USE ONLY: ****************************** ~~******.****** * ****** ** ****1\*..********** ***** *******
~PECTIONS REQUIRED: FIling Fees. _~'6 (1 0 rf)
_ . Base Inspections: ;;Z 1S 7. SV # Charged Re-
pper Foot 9 Lower Footing Under S b ~6 "0 ReViews
~~_~ Cert. of Occupancy: -...)., '-'
~ In Meter IJase .' /
P.R.I.F.: Pale{ PreYlouoS 1 Additional Fees
h::~ ' TOTA . /'1?. 3. &0
RevieWed/Approved: Dept. of Community Services
S:Permits/Forms/ILP RESIDENTIAL
(Date)
07