HomeMy WebLinkAbout07060162 Application
City of Carmel/Clay Township Permit #:070100 IliJ2
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:
NAME:
STREET ADDRESS:
. '8. 1\1:1.; fJ Bu; lJ.u
715 IE':
1071'..... s--r
BUILDER'S EMAIL ADDRESS:
ol<^ V; d G:>
NAME:
KI iN.6eJ'Y"\
.....,.
13Q N 2--
STREET ADDRESS:
LOT #:
//.j0,
(QI'
l.JB~
WL5I .cl q
SQUARE
FOOTAGE:
ADDRESS OF CONSTRUcrrON:
d3/0
cn2W
SEWER UTIlITY
PROVIDER:
PHONE:
FAX:
8tt!o-d.-070
8410- '-134 '1
CITY:
):",,01.; N
STATE:
01,,::>
ZIP:
4(P~BO
BEST METHOD OF CONTACf:
RELE
PHONE: S~ject to cil..m'plia~ce wiffll\i,11 regulations;
o 4 ~1'5~~& Local Co ,
CITY: EPT OF COM;fl:A'i]:NITY SE~CES
lCl.1i-YrGf'CARiVlEL I ^
SECTIo'lNDiAN ZONING:;::::> \
5"OO~ \ ucl
3C1
ESTIMATED COST OF CONSTRUcrrON:
(EXCLUDING LAND VALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN CQMMI$SlON I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
flOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
)8 SINGLEFAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
Early Release
Permit:
PROJECT INFORMATION:
Lot Split:
_y -G)
-y ----0
y...
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 DEMOLmON
Manufactured
Trusses: -y----0
Sump Pump: ---&--N
TAXf~P~PARq:~,#~ ,:.
'l......-..,
PLUMBING CONTRACTOR:
PI~~-r..1.,~t~ ~~:~ #:
8 tt / DO do q Lj Pi
Which plumbing codes will be applied to the construction:
%Intemational Residential Code wjlndiana Amendments
o Uniform Plumbing Code wjlndiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB ~ BASEMENT (WALKOUT:_y----Q)
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 (Certificare 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, Df alteration of a structure, or any change in the use of land or structures
requested by this application wilt comply with, and confonn to, all applicable laws of the State of Indiana, and the UZoning Ordinance of Cannel 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 ODor 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 be theD to 0 Unityservices~7:.;:anabOQJ{e hl;>,/07
Signature of Owner or Auth gent Print Date
R
S:Permits/Forms/ILP RESIDENTIAL
Dept of Commumty Services
# Charged Re-
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