HomeMy WebLinkAbout07040205 Application
City of Carmel/Clay Township Permit#: 07010 ~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICAi!'ION
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:
~/Ulv'" (ili'*UM bv'I.l:>8l", TNe-.
=In - sq5 -crDq~
FAX:
317-9l.s;-U""
CITY: STATE:
.~"l>1t po(..\<; I,..l
BEST METHOD_ ~F CONTACT:
u> P(05~ev u II
STREET ADDRESS:
8s8'3 tILA\' ':if. jtlOO
ZIP:
<tb2>Z>
BUILDER'S EMAIL ADDRESS:
';l>1l1Sh/V~
STREET ADDRESS:
~IML
NAME:
LOT#: \" b
3/"7-11-+-r"782
Mo~o~ ~ M.Ao,.J, u,c
PHONE:
FAX:
<;.,,~
CITY:
STATE:
ZIP:
SUBDIVISION NAME: \
MO~DI-' ~ MAI,l
SEmON:
pub
/, ~II -*
ZONING:
ADDRESS OF CONSTRUcnON:
LlL( r:\,o~ ~.
OI\IZ<Mc<\.-- r,.\
,*,,"2.-~ Z
SQUARE
FOOTAGE:
t-II~
FLOOD ZONE AREA DESIGNATlON(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
S TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
_yXN
_yl{N
WATER UllLfTY
PROVIDER:
ESTIMATED COST OF CONSTRumON:
(EXCLUDING LAND VALUE)
l!.PrfU>tet.
417--;) DD 1:>
\
Pub f'2.l:....,l'" J>~
f.lp Ai.<K ;lI:Ol{O(Vo3(, o'to-lC>oSS""Z.
TAX MAP PARCEL #: I'-"'t -7 S--c>z. -0;>-0",. ,~,
\b-O"1-2s-cn..-o].-02-(.UlO
NAME OF UTILITY EXCAVATION CONTRACTOR; Pu\N COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); ANDIOR COUNTY WELL ANDIOR SEPTIC RMIT #'5 (IF APPUCABLE):
Early Release
Permit:
Lot Split:
o OL 0 I
TYPE !IV t. ;:0"" PLUMBING CONTRACTOR:
k[ NE stJw. .~" <I' ~"o. CO. (2-~ f2- fv.'V\JS LI""'f
o ROOM ADQ!f 9 'icy "~::9I\r:..h. er's Indiana State License #:
o PORCH ADD (~; (,0 ".; "'091, 'c 3S;-
o DECKADDITIO' ~ V/V~O<l'/at1qt v('~ tP!?€o 001 .
o REMODEL M(L)....( ~ r~ fi'~.:~~C 4::)........es will be applied to the construction:
Basement.~ln'!l} dn~ cS.~.o:~~' ~ :""V-
o ACCESSORY BUILDIN!i~ Y ;-~l!3tern~al Residential Code w IIndiana Amendments
o DETACHED GARAGE" ();.... 7Cl...-. .
o ATTACHED GARAGE ~.-P.::.:~U'" Plumbing Code w/Indlana Amendments
o DEMOLITION ;s'N, - -
FODNDATION TYPE: (Check all that apply for the new
construction area)
Manufactured
Trusses:
.K.Y_N
_Y.1(N
o CRAWLSPACE
o POST &
BEAM _PIER
Sump Pump:
~ SLAB
o BASEMENT (WALKOLrr:_Y~N)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences wi~hin 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. qass I
structure petmits 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 structu~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 - 1993n (Z~
289) and amendments, adopted under authority of l,e 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 Certificate of
Occupancy s e iSSUy.z.~h\;\CfCommurntysenices.c"'2~;~m~_ 1\~ If('Z4:~
Signature 01 Owner or Au orized Agent Print Date
OFFICEUSEONLY:******************************~~***********~*******************~***************
INSPECTIONS REQUIRED: FIling Fees: S '3,~ , / ,
~ . _ Base Inspections: O(,?S 7. 51) # Charged Re-
~tlng Lower Footing 5 ""'0 ReVlews
_ ~ Cert. of Occupancy: 5 ~' ~
~Mi, ~ase inal '\ P.R.I.F.: re/d fnZAI/()U.siY Additional Fees
wL ~ TOTAL: / ;;;l.'6, It()
Reviewed/Approved: Dept. of Community ervices (Date)
S:Permits/Forms/ILP RESIDENTIAL