HomeMy WebLinkAbout07060149 Application
City of Carmel/Clay Township Permit #f'l'o601 f'7
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
i
I
I
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER UTILITY
PROVIDER:
PHONE:
FAX:
SrEv'~ Ca
STRl\ 3D~SS~ lJM e-.r~ .
FLOOD ZONE AREA DESIGNATlON{S)
FOR THIS PROPERTY:
NAME:
, ~FD,-
V'I'iL STT N
43 ( - If-I
BUILDER'S EMAIL AD~C:.- q L(-
BEST METHOD OF ONTACT:
STREET ADDRESS:
~O'L-
LOT #:
-1~o '2...-
FAX:
S7 I -ObG
zq.-G cY;S
STATE:
:eN
SUBDIVISION NAME:
SECTION:
ZONING:
r
...
~
SQUARE 07\
FDOTAGE: OV
LfLk
ADDRESS OF CONSTRUCTION:
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.)
[y
PROJECT INFORMATION:
_Y~N
_Y-f-N
S;Permits/forms/llP RESIDENTIAL
.
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA
NUMBERS; TAC DATE(S); ANDIOR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TAX MAP PARCEL #:
TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR: 17/ .. "
o NEW STRUCTURE ~ P rJ tUlV r UM-b~
g :g~~:~~fD FOR ~ ~I~ License #:
o DECKAD6miJlll(sjl compliance with all reQulatlons
"?- REM~DEL . 91 State and WilIdl1p\;,\/Iilll.i.codes will be applied to the const,uction: ,
o ACCESa;mUt~~M M ~l;Q(~Ja,\{I~liiential Code w /Indiana Amendments
o DETACQIJl(A(i)i6CARMEL Lf"1 IJ.V Tf'lWJ\lS::I-lIP .
o ATTACHED GARAGE LYtllil1'orlrN'lV1hMtl'g'Code w/Ind,ana Amendments
INDIANA
o DEMOLITION FOUNDATION TYPE: (Check all that apply for the new
construction area)
~LSPACE
Manufactured
Trusses:
_yLN
_Y~N
o POST &
BEAM _PIER
Early Release
Permit:
Lot Split:
o SLAB
o BASEMENT (WALKOUT:_Y_N )
Sump Pump:
For Single Family and Two Family dwellings. additions. remodels, and/or accessory structures, this pennit is valid only if construction commences wi~hin 180
days of the date of issuance of the building pennir, and must be completed (Certificate 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 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 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
o n issued by the Department of Community Services, CarrI?-el, Indiana. /" ~
S. I t::::1J ~ \....6 ~ ~ c.. l '6 0
Signature of Owner or Authoriz gen Print . . ___. Date
OFFICE USE ONLY: ************* ** ****** *********************** ***** ****1* ****** ******************* *
INSPECTIONS REQUIRED: Filing Fees: , ~7' 50
Base Inspections: II )- ~ 0
.
.)J: <sO
Lower Footing Under Slab
Meter Base € s~ '
~;
ReViewed/Approved: Dept. of Community Services (Date)
Upper Footing
~
tuli/
# Charged Re-
Reviews
Cert. of Occupancy:
P.R.I.F.:
~ALa -#30/
~ (~t9'~-,
fee Recelved by:
Additional Fees
O()
Date