HomeMy WebLinkAbout07060043 Application
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City of Carmel! Clay Township Permit #: (j /0 ra OfYf3
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
NAME:
PHONE:
f3/bl~ 4o,J~ !)ulWGU :r:,..e-. 317-<;r(~- C/oqS-
FAX:
'3n-S'"'4~-2{~1
STREET ADDRESS:
83g'? c.e+/<t 7'r' if/DO
BUILDER'S EMAIL ADDRESS:
{;MoSk4- I'~;(,kv.., &>[,<.....
PROPERTY
OWNER:
NAME:
J\!1o"'o..J
,
. MA "..I I u.-c..
STREET ADDRESS:
S.1.1'\A.l <U a.~I/L--
LOCATION
& PROJECT
INFO:
LOT #:
IS€'
SUBDIVISION NAME:
MQr'l>~
"1 MA\~
ADDRESS OF CONSTRUcrrON:
13 ~~,,~ ~
SEWER UTILITY
PROVIDER: CfI'€'Wl!?L.-
WATER UTILITY
PROVIDER: CA.e-IV\~L.--
CITY:
r:,., bl4-..J I1;l'bu,>
STATE:
J--,J
ZIP:
4b"2.~
BEST METHOD OF CONTACT:
(:. /I1iJ~k"V dO In- I -S7fh.....-
PHONE:
<<-b.,v;::
STATE:
ZIP:
S<i."',,- 0.4
cm:
5 ON:
bA 1I1,J<..1
ZONING:
fvb.
CA tZMeL I r:,.J 'tb '2T2.
SQUARE
FOOTAGE:
J,loZ If'
ESTIMATED COST OF CONSTRUcnON: "'"/-'1 ~
(EXCLUDING LAND VALUE) or PV I OPt:>
..,w:' alV~""4 (.lb rzc;-z.c,>(j
DP AJ>4 Jl;O~CIOl>? oi.f-~ 00 %"2.-
TAX MAP PARCEL #: If, -"'l-'J!> -02 -c>'I -D'U>.ao <>
If, -C4-~-o"2- -o=; -o?-l. 0<=
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNn WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
Jli1:'"TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
'W~6 .,~ 'l.lnshed-ut
TYPE OF IMPROVEMENT:
~
o
o
o
o
NEW STRUCTURE
ROOM ADDITION(S)
PORCH ADDITION(S)
DECK ADDITION(S)
REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
PLUMBING CONTRACTOR:
12~,e.. P\.->MBl~
Plumber's Indiana State License #:
GP~~vi>(3~
Which plumbing codes will be applied to the construction:
~ International Residential Code w!Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
Manufactured construction area)
_y -KN Trusses: ~Y _N Cl\ON 0 CRAWLSPACE 0 POST & BEAM _PIER
Lot Split: _Y XN Sump Pump: Orre~I~~g\.l\a\iO(\B ~ SLAB 0 BASEMENT (WALKOLrr:_Y~N )
For Single Family and Two Family dwe~.1iW~~\!~.~. C .~~V1G~~t ~this permit is valid only if construction commences within 180
days of the date of issuance of the buiJ~t, ~t~'cbm~lt:'fe.d.CCcx ~u cy issued) within 18 months of the issuance date, Class I
structure permits are subject to the General AdrnirlI6\a~e:a~~;Rtj\e1stL.ft or' . AC 12) regarding expira.tion time frames for beginning and
0'- Of C,!\ '~om~' 01 ion. '
I. the undersigned, agree that any constructQ~~c~w~~~n , re ocation. or alteration of a structure, or any change in the use of land or structures
requested by thIS application will comply vyitJr.t:nfi ~otm t~r~li~RW~~l of the State of Indiana, and the "Zoning Ordinance of Cannel Indiana - 1993~ (Z~
289) and amendments. adopted under auth~ty'of I.C 36~7 et seq, Clti1Wal Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kItchen, b~~oor drams are connected to the samtary sewer I further certify that the constructIOn will not be used or occupIed until a Certihcate of
Occupanc. Sf; lTed kh: DeQruruty Semees, cm~~;a M. fI1 DStWL ~/ J 0 I
Signature of Owner or Ek-orUed Agent Print Date '
OFFICEUSEONLY:****************************************************~***************************
F'I' F ") r-r u ;z;O
INSPECTIONS REQUIRED" I mg ees: _ I I B --
€e'r FO~ Lower Footing Under Slab Base Inspections: Z }~. ~
. ~~ Cert. of Occupancy: ' _
~U9h I'0'~ Final Site ~,K.I.f.: l!e{!ir} ~PCZ;c(
TOT L' I
PROJECT INFORMATION:
Early Release
Permit:
I
Reviewed/Ap oved: Dept. of Community Services
S:PermltsjFormsjllP RESIDENTIAL
Fee ecelved by:
# Charged Re.
Re'views
Additional Fees