HomeMy WebLinkAbout07060234 Application
City of Carmel/Clay Township
RE~IDE~TIAL IMPROVE~NT LOCATI~N r,..E~M.r;t~f~W~pN
For Smgle Family, Town Home, & Two Family: New Structur ,Pll.<I.iti&ns,:Rl.mOdEiISi & ACC;e~!lry,~r!ll$Jres
_....\ t,--, "'n 1 lienee wltn ad . ,-'~ '\
BUILDER NAME: ~ /J /J () St~~ L?~ '-'~~ll ~
OF I'A'VJ ,~(!) f<.M1 N r.-~~fl.1M\..;N\T~"q~
RECORD: STREETtrD~rt '- tWA aNi (/j. F ~Ar7i.eL :A~'.\ ;~~ '3 3
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I
BUILDER'S EMAIl ADDRESS:
"'. Roe t+t.-I/'oJ
NAME: S~
LOT #: SUBDIVISION NAME:
3 0
ADDRESS 3 (~r~RICTlO 6 o'i. cLd.R.A c.J;::
WATER UTIUTY _ _ _ _ (J
PROVIDER: ~
PROPERTY
OWNER:
STREET ADDRESS:
LOCATION
& PROJECT
INFO:
SEWER UTILITY
PROVIDER;
Permit #:-0 7()/POJ ?JY-
PHONE:
I (j /
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j
'",,",'-.....
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CITY:
ST~TE:
'J
<'CO? ZIP:
-.....,......
SECTION: ""'-.....
:r "'.
ESTIMATED COST OF CONSTRumON:
(EXCLUDING LAND VALUE) Sq 0 000
as...,;t
p vt\ '1:fZl h7J 'if'! - TCJ 6 '1
TAX MAP PARCEL #:
1 - o~ -.30 -oo-cXC-03'f. 00
PLUMBING CONTRACTOR: (,v-+T~ - f3A4
CDS ~'C1'n0 008 PUWl'rP"'l
Plumber's Indiana State License #: (IV"" S,-Il<>N J; ')
.-tf J(') q(O 0000'1 "l Rq-s-lfdS
NAME OF UTIlITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
~ 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~
_Y~N
O'10Ip01.~ <
(110
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
Manufactured
Trusses:
Sump Pump:
Y~
~N
Which plumbing codes will be applied to the construction:
d International Residential Code w IIndiana Amendments
~ Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o
o
CRAWLSPACE 0 POST & BEAM PIER
SLAB 1):[ BASEMENT (WALKOUT: v-:;- N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is valid only if construction conunences within 180
days of the date of issuance of the building permit, 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 Cannel Indiana - 1993" (Zc
289) and amendments, adopted under authority of l.c. 36~7 et seq, General Ass~mbly 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
Occup yhas been issued by the epart of.Cbmmunity rvices, carnie!, Indiana.
/ M-dvJd ~<Jefft-(;v
S;PermltsfForms/llP RESIDENTIAL
Fee Received by:
Date
# Charged Re'
Reviews
Additional Fees
Date