HomeMy WebLinkAbout07060171 Application
City of Carmel/Clay Township Permit #: 0100 017/
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER UTIlITY ~
PROVIDER: C ffic.f
NAME:
I'M MwJ d
I2Deh (/1'.1
STREET ADDRESS:
/" 2-'2.... BIZ
BUILDER'S EMAIL ADDRESS:
R /<. /2oe It UN
j)~
NAME:
STREET ADDRESS:
LOT #:
:2,S"
BEST METHOD OF CONTAcr:
([1((;,- Pt-r I drt. I fS-7{(P(,
I c[ r\\ f(, C;, ;' ; ~Axl -:~// is \ ::\\ II
l,j Il~:': ~-:-~" \/ ~ \1
[II LI \ STATE: ZIPI':I\ I
I,nl
IUs~ !? {
c. (Rc0i
PHONE:
3{1- gl1G.- g89 r
FAX:
cm:
~
STATE:
IN
AoL . Cow,
~
SUBDIVISION NAME:
GLerJ oA-;
.~
~.
.
PHONE:
CITY:
ESTIMATED COST OF CONSTRUcnON:
(EXCLUDING LAND VALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I aZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
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.)
Early Release
Permit:
PROJECT INFORMATION:
yv(
yVr;
Lot Split:
tV.
TYPE OF IMPROVEMENT:
tilt 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 DEMOLITION
Manufactured
Trusses:
Sump Pump:
yv(
~N
fQ,tM ;ro Wl\J - ~
TAX MAP PARCEL #: 0
Plumber's Indiana State license #:
000 cO 'f
3\1
$11'''IIS"3
ZIP:
6.033
SQUARE
'110
000
(Ai -13ft<1
00 c:-st:Irv(yr1-v.
-roM ~Ta.OOi'iJ q
Which plumbing codes will be. applied to the construction:
o International Residential Code w IIndiana Amendments
~ Uniform Plumbing Code wI Indiana Amendments
i.t!1>i ~ ~ pe.- :
. FOUNDATION iYP~: (Check all that apply for the new
construction area) .
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB ~ASEMENT (WALKOUT:_Y Vr;;
For Single Family and Two Family dwellings, 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 permit, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. C1!l5s I
structure permits are subject to the General Administrative Rules ~f 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
Oeeup eyl"s been issued by the Dep nt of Conununity Setviees, ~~ 11/ d ,toe ~ 1/ AJS (P !f cr./ OJ
Signature wner or Authorized Agent Print 'fI- Date
OFFICE USE ONLY: **************************** * *** * ********************* ***************************
INSPECTIONS RE UIRED: Filing Fees: ;/ e? I jJ, ~J
. . Base Inspections: d2 rf!,:"7- ::s::::: 0
Upper Footing Lower Footing Under Slab . r rFl
Cert of Occupancy: -.s, .J ..) v
Si~ / 0
P.R.LF.: ,..;:2 C f. a Additional Fees
TOTAL:< tI ;;;2g> ,),,<. -yU
Revie
# Charged Re-
ReViews
Fee Received by;
Date