HomeMy WebLinkAbout07060117 Application
NAME Of UTlU1Y EXCAVATION CONTRA R; PLAN COMMISSIO"\.{ ~/ BP ;~/j ONS'"
NUMBERS; TAC OATE(S); AND/OR COUNTY WELL AND/OR SEPTIC ~t'S FStttlti0,SflIJ.CS Wit tRUe
Or:: c OMMu CEil d Q~W #:
'A.AM Nlly Ss. [;
TYPE OF IMPROVEMENT: INDiA
o NEW STRUCTURE Ihd'L SHIP
o ROOM ADDITION(S) '" .....J Plumber's Indiana State License #:
~ PORCH ADDITION(S"'" "1""-
i;!i DECK ADDITION(S) ,
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER UTlU1Y
. PROVIDER:
City of Carmel/Clay Township Permit #:1l1/J.kfl.1l1
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
NAME:
PHONE:
" 37-'if3lf2...
CITY:
'....eIL
STREET ADDRESS:
5'lcr
I' l-l/,.
BEST METHOD Oll C'PI11 ACT:
tf os- 0 O"t-S2...
x
IS
,,~ Tl:f(
"
BUILDER'S EMAIl ADDRESS:
NAME: .
R.'-l.-~IY S /I/)e
PHONE:
40 <i'-qol
FAX:
STREET ADDRESS:
CITY:
C,AK....e .
STATE:
X"1.-
ZIP:
l.{ c. CJ 3
lONING: K \
De.
SECTION:
LOT #:
;;l4
SUBDIVISION NAME:
ADDRESS OF CONSTRUCTION:
14 ~3 S,
CavWle-l
SQUARE
FOOTAGE: I 52
bit
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LANO VALUE) /2.s-lf /. 0 cJ
WATER UTIlfTY
ROVIDER:
TYPE OF CONSTRUCTION:
M SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions, Remodels. Etc. \
Which plumbing codes will be applied to the Olnstruct.ion~
o International Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
vi Man~actu~d
Y N 1MTrusses:
Y ~. ~ump Pump:
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Early Release
Permit:
PROJECT INFORMATION:
Lot Split:
_Y "-~
_Y~N
o CRAWLSPACE 6. POST & _ BEAM _PIER
o SLAB 0 BASEMENT (WALKOlfT:_Y_N)
For Single Family and Two Family dwelhngs, 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 pennits are subject to the Generill. 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 consrructio,n...recon--strUCtion, enlargement~16cation, or alteration of a structure, or any change in the use of land or structures
requested by this application will com l)"-wiEb, and conform to, all applicable laws of~e State of Indiana, and the ~Zoning Ordinance of Carmel Indiana - 1993" (Z-
289) and amendments, adopted un 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 connected to the sanitary sewer. I further certify 1){at the construction will not be used or occupied until a Certificate of
Occupancy has been iss y the Departrn.ent of Community Servi~ce'1 ~a'nneJ(fndiana.
. . . 'J'~P1/tft ,"Ui.rA ~-/(F07
gnature of OWner or Authorized Agent Print Date
OFFICE USE ONLY: **************.a::***************************************~**
INSPECTIONS REQUIRED: Filing Fees: .5 '
Base Inspections:
Cert. of Occupancy:
Upper Footing
0o';g~
Lower Footing
Under Slab
# Charged Re-
Reviews
*****************
Site
Meter Base
'w TOTA 'Lac ;I y;J. ,p;"';
~ ~ p:x-/o?
F Ived y: Datel
Reviewed/Approved: Dept. of Community Services
S:Permits/Forms/IlP RESIDENTIAL
(Date)