HomeMy WebLinkAbout07060208 Application
_. City of Carmel/Clay Township Permit #:Dl D(gl.lZD~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
CnY:
R
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rgss 1 ~NSTR~UJJ I\J II'J6 +AM Itb:~- -._':_-'--:_<~ !!!
SEWER UTILnY n ^ n I j WATER UTILITY 11I111 AftD ~DS'f-llfICONsTRUmClN:
PROVIDER: ~\e;L PROVIDER: CA/2Jvt6,~ L J (EXCLU6ING-LAN\jI>iALUEri! II! 1
NAME OF lITllfTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET ^~-,-" A j i L./ i I
NUMBERS; TAC DATE(S); AND/OR COUNn WELL AND/OR SEPTIC PERMIT ,'5 (IF APpLiCA8lE):_J.2~l 0 Ic,..-e r<11[)Q 6 XC
FLOOD ZONE AREA DESIGNATION(S),/ ., TAX ~~9i~-';-...J 00 0
FOR THIS PROPERTY: ^ - U1- I(.,{ -- .. I - 02.2-.0
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
NAMh
rLLLTE l--li r'Y1w
STREET A1'5ss: 0 N mE: ( I AN -S-T CnY:
BUILDER'S EMAIl ADDRESS:
J DANI\lE: .SHE Pt--IEJ2JJ
NAME:
STREET ADDRESS:
LOT #:
22-
TYPE OF CONSTRUcnON:
(])I" 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:
-y~
_YvN
Lot Split:
mE.
TYPE OF IMPROVEMENT:
~EW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE ~
o DEMOLmON
Manufactured
Trusses:
Sump Pump:
v:.
~-N
FAX:
%03:1.
BEST METHOD OF CONTACT:
Ef1AIL
PHONE:
FAX:
STATE:
ZIP:
SECTION:
i.
ZONINS -1
SQUARE
FOOTAGE:
SOq
o
I tJ c..
Whi9' plumbing f/i'lll~~e (Q'Y6ctlon:
5?' Intemati~&os(t'}'~~~ri<<dl'!l'..,;;\1(mendments
o Uniform Plumb~'dt.J',~men~ments
FOUNDATION TYPE: (Check ~j't~PPIY for the new
construction area) "1;,0
o CRAWLSPACE 0 POST & _ BEAM _PIER
o SLAB o.-/s'ASEMENT (WALKOlIT:_ Y ----tiN )
For Single Family and Two Family dwellings. additions, remodels, and/or accessory structures, this pennit is valid only if construction commences widtih 180
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure permits 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 LC. 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
Occupancy has been issued by the Department of onununity Services, Cannel, Indiana.
'-.!,O/I- tJ tJ E. .s ~ EPH f. QJ'l
Print
*******************
9c?
c? .50
Cert. of Occupancy: SD"- JZ!
P.R.I.F.: (,..7 t/ 00 Additional Fees
~~d5~YO
Fee Received by:
(o /).J)! 07
o.te
USEONLY:******************************************************
Filing Fees:
Base Inspections:
Reviewed/Approved: Dept. of Community Services
S:PermIts/FormS/ILP RESIDENTIAL
(Date)
# Charged Re-
Reviews
Date