HomeMy WebLinkAbout07050188 Application
City of Carmel/Clay Township Permit #: 0/7050128
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:
bR.
BUILDER'S EMAIl ADDRESS:
<>.II)
TYPE OF CONSTRUCTION:
o SINGLE FAMIL V
o TOWN HOME
o TWO FAMIL V
# of units being
constructed at this
~E~~e~NTIAL (For
Additions. Remodels. Etc.)
SEWER UTILITY WATER UTILITY
PROVIDER: C PROVIDER: C A
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY' WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE): J
FLOOD ZONE AREA DESIGNATlON(S)
FOR THIS PROPERTY:
Ii/xlt
-
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_v4
_Y -.LN
PLUMBING CONTRACTOR:
~ E. SM;:rfl-::-~~-0~'.. -'i .-
Plumber's IndianaiState'License' #:_ ~ II ","
/D1777 11/)/1----- I"
~;c plumbing eo,W ,),111 be .III>AIJll ~ "l! C6rtst.;uctiO~:! ill
III III Lvu, 'II!
International: Residential Code w IIndiana A~endrrients
o Uniform Plu~~in;l:ocie wtIiiOia",i-Ajjjendmi~~il
'- I. L I;
FOU N DA TlON TYPE:(Check'ali'that'.pply,for.the!new
construction area)
,;;, N
~ /N FoY~js
- - AdAitll>i1
TYPE OF IMPROVEMENT:
o ."NEW STRUCTURE
rn' ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORV BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION I
Manufactured
Trusses:
Sump Pump:
PHONE:
FAX:
OTY:
I
STATE:
..L
ZIP:
17-6
5
BEST METHOD OF CONTACT:
FAX:
CITY:
It.lb"
STATE:
IN
ZIP:
iffo:27f?
5
SECTION:
3
ZONING:
$-
SQUARE
FOOTAGE:
ESTIMATED COST OF CONSj~WCTION:
(EXCLUDING LAND VALUE)". '8 '{J
TAX MAP PARCEL #:
o CRAWLSPACE 0 POST & 6EAM PIER
o SLA6 cif6ASEMENT (WALKOUT:_Y ~)
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 (Ce.rtificate 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 In~" 'ND lTlQ1At- ,." , ames for beginning and
completing cons to ' ~.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, 0 era' a', ie' .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 LC. 36-7 ec.seq:Ge eral Assembly of the State of Indiana, and all Acts amendatol)' theretoo I furthercerrify that only
kitchen, bath. and floor drains are connected to the sani6lry sewer. I fur er certify that the construction will not be used or occupied until a Certificate of
o upancy has been issued by the Department-<rl Co uni y $e . ces, annel, Indiana.
. .t)" -' b ~ shllo7
Signature of Owner or Authorized Ag Date
INSPECTIONS REQUIRED:
Upper Footing piWer Footi!!9> Un
~ghln) MeterBase ~-~
*************************~**************************
Filing Fees: / d, (Jc?l--
Base Inspections: I / -;? ;;2. :5"0
,
S:S-. ~O
P.R.I.F.:
Cert. of Occupancy:
# Charged Re.
ReViews
-(J7
(Date)
Fee Received by:
TOTAL:
Additional Fees
# 376. 0),
,
11, '
'.evlewedjA proved: Dept. of Community Services
PermitsjFormS/ILP RESIDENTIAL
\
Date