HomeMy WebLinkAbout07060029 Application
City of Carmel/Clay Township Permit #: ()70 {e (JO.;z cr
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME: B PHONE: FAX:
{Low 4'v~ tN I I-oue; IfJe-. 3/7 - )t/s>qo<( s 3t7-~4.~-21(,(
OF ,
RECORD: STREET ADDRESS: tt-IDO CITY: STATE: ZIP:
~3g5 C.11-Ac/t( 91. r:,.,OIAfoJA(b(.(S r:~ L(-(,z')z>
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
.qM..;h<!v6-qo",~bv;ld<!v<. """,- (t.-#- M~s~ rell 31(_lf'f-r7az.
PROPERTY NAME: , PHONE: FAX:
OWNER: Motlt),J ~ Mk/,1, L-t.-c. ~MLtA.'" O-b~v&
STREET ADDRESS: CITY: STATE: ZIP:
C;L~ .'<A ",-t.><> "'i..-
LOCATION lO(4~ SUBDIVISION NAME: ~ {VA'> 40.. ~)ON: ZONING: puA
I!t PROJECT MONP.N '7 MA\~
INFO: ADDRESS OF CONFucrrON: <k(,2..1'2- SQUARE 2,10"\ ~
2- :s 5' 7"< qr ,JfI'J ~el.-, r:~ FOOTAGE:
SEWER UTILITY efl~"1.Cl- I WATER UTILITY C f\ r2"'1-a- T ESTIMATED COST OF CONSTRUCTION: 4120 lOOO
PROVIDER: PROVIDER: (EXCLUDING LAND VALUE)
I
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / B'iJ!I'fj~3 &, l.v: r 8XCAV"TI"'4 f..>/; f2-f!i29~ bo(.~
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT # BLE)' bp I A t.-~ It ol{ol tx>3b oL{Oloo,;5"Z-
FLOOD ZONE AREA DESIGNATION(S) "K" lA.ll"S~ TAX MAP PARCEL #: II. -d-j - 2.., -07. -~;) _il"",..wJ
FOR THIS PROPERlY: w~ I~ -d{ -~-D'L-D,! -0"1-1. "cD
TYPE OF IMPROVEMENT:
~ NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLu;tON
,-<;,\O~
.>.- Ma~~!l(\o{\~ V
_Y "N ~~~~0W ::\-Y _N 0 CRAWLSPACE
~<IlCp~1 ..:5 L-
Lot Split: _Y ~ c,c 'l"~\ Go&ft'?i-J\C":~ ~N ~ SLAB 0 BASEMENT (WALKOlJT:_Y_N)
For Single. F_~~ w lX~~~~~l~ Odds, and/or accessory structures, this pennit is valid only if construction commences within ISO
days of t~o~~~~I-fl; ~~~~tNiI::, .fttO must be completed (Certifi~ate of Occupancy issued) wi.thin 18 .mo?ths .of the issuance da~e. ~lass 1
structure p~e 's~~t ~(!)~ne ~istrative Rules of the State of IndIana (See 675 IAC 12) regardmg eXpIratIOn tUlle frames for begmnmg and
r-.X' \.;) _"'l\'e~~ completing constrUction.
I, the undersign~GP'''\ t'Mt~~]f ,construction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by thi~~)Jr!iia;tW-~ comp~ lth, and conform to, all applicable laws of the State of Indiana, and the uZoning Ordinance of Carmel Indiana - 1993'" (Z~
289) and amen~(mf:li:eq 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 an(u\''or-drains are connected t he sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occup yhas.b issyed by the p'e~art t of Community Services, Carmel, Indiana.
lvl - /Jv( S (0 IT .,...... Mv~ tf;;;tZ. pi vi 0 1
r Authorized Agent Print Date
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
~ TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
~
PLUMBING CONTRACTOR:
(2~/L Pv->,,,,BI~
Plumber's Indiana state license #:
Cf'iif&'DO /3.J'"
Which plumbing codes will be applied to the construction:
~Intemational Residential Code w/Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o POST &
BEAM _PIER
# Charged Re-
ReViews
Site
Cert. of Occupancy:
P..R-:t:F ..
C. tL,~ I h- -0
Reviewed/Ap roved: Dept. of Community Services (Date)
S;Permits/FormsjIlP RESIDENTIAL