HomeMy WebLinkAbout07060023 Application
City of Carmel/Clay Township Permit #: [JJDb 0023
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Strufiures
.
i
,
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
NAME: S-re.Pl-IeNS<:N ~iCbJTlAl.
STREET ADDRESS:
Cj2S ~'51 I::'e-IVe:..
BUILDER'S EMAIL ADDRESS:
NAME:
-rOM · ~Nl-i"( .t-!oC:>OWAl-
STREET ADDRESS:
L\b':::> Mc.Ue.al LAkJE.
LOT #: 4"0 SUBDIVISION NAME:
V.JIWA/1'l<;;'
ADDRESS OF CONSTRUCTlON:
Lild? fv\c;..LAeeN
IAN€.
SEWER UTIL
PROVIDER:
WATER UTIlITY
PROVIDER:
PHONE:(k.S) l\VS --0"'\,'0
FAX:
-
CITY:
STATE:
ZIP: t./boll
ANoEILSoN
It-J
PHONE:
BEST METHOD':OF'C:ONTACT:
/-~~
~'- "7(,5 Y2S-
.-
(~ ~ FAX:
~\ s--~'L::z.o3 . .~. . _
,
'OCC1~'
'I
~'
-.~J:~
CITY: STATE: ZIP:
CA~SED FOR <OONSTAUOOO1ll7-
Subje~mplianc vti\~I : r u a Ions
rvlll1.:.. of State and L cal Cod .-
DEPT
CITY OF CARMEL /
ESTIMATED COST OF cON~!'lA _
(EXCLUDING LANDVALUE)-~~~~o.,~
1..--, r" '~,:r t1 \\fi!..-. 1.'-,,\'
IIJ)rl'::"'~7.~_lL~~1\\ \11
TAX MAt'PAR~EL # JUN 5 2007 I I
.11 \\1 '
IW wi
PLUMBING CONTRAClTeR:
L
IP
NAME OF UTILITY EXCAVATION CONTRAcrOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
~~ONE':A~~9ESIGNATION(S) X
FORTHIS PROPERTY;
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
O. ~OOI'l.~DDITI~ON(SL
~PORCH_ADDITION 6 .
~ADDITIi N(S) Itll
o REMODEL L
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
TYPE OF CONSTRUCTI
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_Y~N
_Y~N
Manufactured
Trusses:
Sump Pump:
_YLN
_YLN
/0
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction: !
o International Residential Code wjIndiana Amendn;tents
o Uniform Plumbing Code wjIndiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE
I8l
o POST &
BEAM _PIER
SLAB
o BASEMENT (WALKOUT:_Y_N)
For Single Family and Two Family dwel~gs, additions, remodels, and/or accessory structures, this permit is valid only if construction commences wi~hin 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. qass I
structure pennits 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
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of 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 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, 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 has been issue by the Department of C u:iiitySetviC€s, Carmel, Indiana.
Sig
"T.
SLCP~
0"'-(05/0-1
Date
OFFICE USE I::~~;~~:*: ::~~::D: **'7&**J.~0~~n;~:::~************7pO,*~~O********** ** *******
B I ct J /7 ') ) # Charged Re.
f IU .nO;"" ":A . U d SI b ase nspe Ions: . /0<- ,
'--- pper FO~ ~ower Footing n er a . ReViews
_ - Cert. of Occupancy: S".f" . fI'J
C RoUgh In .-Meter Ba Final Si
P. RJ. F. : Additional Fees
~. TOTAL:../) Ii L/D.f>. If
~~"cv~ '
Fee Received by:
Date