HomeMy WebLinkAbout07050238 Application
BUILDER of
RECORD:
qJa;,OJ) + ~t?~7 ~ar)()luL JlLurJiiOf) A _
City of Carmel/ Clay Town&ip 7F Permit #: t) 7 tJ 60 23"ir
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family,~1'Il!@)fl>h3m'e~ew Structures, Additions, Remodels, &. Accessory Str~ctures
I
annan Ins aw PHONE
NAME
FAX
STREET ADDRESS
Indianapolis, IN 46250CITY
ax
STATE
ZIP
PROPERTY
OWNER:
FAX
STREET ADDRESS
CITY
STATE
ZIP
LOCATION
&. PROJECT
INFO:
ZONING:
SEWER UTILITY () 11 I. WATER UTILITY
PROVIDER: CWL PROVIDER:
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 APPLICABLE):
f7 - j SQUARE )'7//"-
c'{V[II2.L1JJJ. 't FOOTAGE: "-I..)
f7 /1 J ,,/1 A /7 E5TlMATED COST OF CONST CTIO~.
r..;.A.{JLJ I Lf-!t.- (EXCLUDING LAND VALUE) /
'k(J{J - PhD TkJJi(J/)i()
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
~OWN HOME
-TI Two FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
~ NEW STRUCTURE C{(J;., LrY'OJ!U ,
o ROOM JrrJ;J~~) Plum er's ~ State LIcense #:
o PORCH ~O /1~/l.)1\r-:-7
o REMOD V&ct to . f:OR ftCj, ( J{J!}.:J
o ACCESllPB~ BU~~1k:"lla~'Wi 1ii6leie7jpl be applied to the construction:
o DETa~~;t'. e af)~cl:!1f~lJ.aNilif@LI!M.n(~tial Code wI Indiana Amendments
o ATTi1t1iir"lt€i Ge:;.OA,fA:.h '~OdE!" onS
DEMO '"ircm CAR'- ov\UNI^mrll'~".'!'mbing Code wI Indiana Amendments
o LI tVIE:L / C l-fllI!lIIt~~lon Code)
PROJECT INFORMATION: IN" Y Tn~''''''C:;S
"'/Ai~NDAn (Check all that apply for the new
Early Release V Manufactured -
Permit: _Y ~N Trusses: X Y _N construction area)
. V \I 0 CRAWLSPACE
Lot Split: _ Y -LL-N Sump Pump: _ Y -A-N ;&'LSLAB
Does any part of the property lie within a special Flood designation area: _Y_N
o
o
POST & BEAM
BASEMENT
WAlKOUT:_ Y ----.eN
For Single Family and Two Family dwellings, additions, remodels. and/or accessory structures, this permit is valid only if construction comme:hces
within 180 days of the date of issuance of the building permit. 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 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 stmcture, or any change in the use of land or
structures requested by this application will comply \\lith, 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. 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
u~~ or TPied unril tl'i~Tt;flZZFYhaS been issue~ 1~~:1;T{)Aj' uf ;;mrHR/;r Carmel. Indiana ,) - ~~ -0 7
Sign7J:l:. (2@Aut.oQ';t'Af.nt Print Date
OFFICE USE ONLY: *********************************************~********>************~****
Filing Fees: 1- ~ ' <3 0
INSPECTIONS REQUIRED: c.n
Base Inspections: 'l P; J. ..:..J U # Charged Re-
T c-""O ReViews
Cert. of Occupancy: ..:J-:.l ,...:::l
P.R.I.F.: 527, tJo
~.M~l1~fcJg)tl)
Additional Fees
Reviewed/Approved: Dept. f Community Services
S;Permits/FormS/ILP RESIDENTIAL
(Date)