HomeMy WebLinkAbout07050024 Application
City of Carmel/Clay Township Permit #: 071)~OOdd
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:
NAME:
6cFFR- 111,
LM'
PHONE: 617~ 'I '5?7'l
'317 'fJ!/,4( , 47 U
FAX: ,,17' ~<lrr f'f<> 7
STREET ADDRESS:
/7 /JPc9t!)l,
BUILDER'S EMAIl ADDRESS:
L.rtW-<:
CITY:
C /M..,n.L f
ZIP:
L/ (pc) 5 z..
STREET AODRESS:
LOT #:
I-{;,{'
STATE:
.DV
BEST METHOD OF CONTACT:
3f7-SI"l '-J'72lJ
PHONE: 317. &<1'1- 5777 FAX: on
~/7' 5;1,11- . LI7Z 0 t.<<. (
~. ~f72 0
,4720
<./WtJ LAVe
SUBDIVISION NAME:
;r""", tt<rl cA
CITY:
L. f
STATE:
ZIP:
Lj 6tJd z..
J;v
ADDRESS OF CQNSTRucnON:
SECTION:
~/l/c,.L
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
_Y~
_YXN
SEWER UTILITY
PROVIDER:
WATER UTIlITY
PROVIDER: (~
SQUARE
FOOTAGE: 1'1 ZI>
ESTIMATED COST OF CONSTRUCTION;
(EXCLUDING LANO VALUE) .:/ c:? Cd ,r)cJO
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATI(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit 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 structur~s
requested by this application wil! 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 LC 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. r further certify thar 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 Certificat of
Occupancy has been issued by the Department of Community~Se Carmel, Indiana.
. \10\.. h- f-fpe'
Signatu thorized Agent
Early Release
Permit:
Lot Split:
/-1/ (J.
;v/A
TYPE OF IMPROVEMENT:
CJ N~RUCTURE
Q--1{()OM ADDITION(S)
o PORCH ADDITION(S
o DECK ADDITION(S)
o REMODEL !).
Basement Finish "IY
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured /
Trusses: _Y ~N
(Check all that apply for the new
o CRAWLSPACE 0 POST & BEAM ----,PIER
o SLAB 0 BASEMENT (WALKOLIT:_ Y _N )
Sump Pump:
t/ Y _N ry.,<;j-,vIC/
Lrf-;?
~
~~FICE USE ONLY: ***************** m***r ~\4t***
~ k ~~ V 0
",(!:,.oINSPECTIONS REQUIRED: <) . Ji
"'footing Lower Footing Under Slab r:J Base Inspections:
"-
"'"Meter Base ~.
'''''5. """) S=/p-o 7
~'Cv"""uI11lYServices (Date)
.DENTlAL
Date
.~*******************J5*~*~***********************
IlIng Fees: . 0 . 90
/ '7 ~, ,s-O
S5"- 00
# Charged Re-
Reviews
Cert, of Occupancy:
,
P,R,I.F,:
Additional Fees
$SYb.5/0
Date