HomeMy WebLinkAbout07060273 Application
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City of Carmel/Clay Township Permit #JJ 7()/oOJ7,
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME: 'Ni \ \ ~ ,', '\ 'n-\-- PHONE: ::Hi \ ~'-\'l 5'-199 FAX:
OF e,ld,\ CO,p 3n\'i,-\3 ~Y.3S
RECORD: STREET ADDRESS: CIW STATE: ZIP:
,-\,,-\ G c-"d l<G D,'\v<Z.- C,.,,-~\ :rn '-l(.,o:'>~
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT: p I,-,~ <:> \"
s..,..,', \ ~ (!) 'Ni \ \ 'Nr-',,\h4 'cIA; Id;", c..o\"pklet:.'E!A9ED FOR"(!;ONSTRlJ€CIIIOfIl"''''<..
PROPERTY NAME: C h \,\<::.1<. ~ PHONE: Subject to compliance Vl'itl:1 all regulations
OWNER: l"nOl-j e I-\a,r.;s of State and Loc,,1 Codes.
STREET ADDRESS: CITY DEPT 01-- CC~}.tn1!JI\JITY ~,"lICES
3'$ ~ Y Br","" Ie", N-..ews. car"OlIW OF CARMEL / CLA~HIP
LOCATION L03VilP SUBDI'dION NAME.:... + SECTION: INDIM hONING:
& PROJECT E en l:: :s+'" .e.::; r '- . I I "\
INFO: ADDRESS OF CQNSTRUCTlON: SQUARE I~
~'S =-"K B,-- IA ...... le'1 '<'r> e.'^J .s. c.o.r~1 ::I-n ,-\,-O~ FOOTAGE: .;<] I
SEWER UTILITY I WATER UTILITY ESTIMATED COST OF CONSTRUCTION: Q.~~
PROVIDER: PROVIDER: (EXCLUDING LAND VAluE). ::ll; ~ ---5'''7-'000 _
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET " .. ..L~/ ~_l; j(~\~',:,!
' ;1- ,
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE): ./; i
, , I -'"iii;;,
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARcE'J i II JUN 2 t -Ii
FOR THIS PROPERTY: ill II; 8 2007 '1/11
,I, .." I I:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
lsi RESIDENTIAL (For
. f' Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
_YLN
_y..2(N
Lot Split:
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o DECK ADDITION(S)
;:& REMODEL ki+c:.he.n
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE ,
)<l. DEMOLITION E" i ",+.,,, ')
ki+c.h'V)
Manufactured
Trusses: _Y _N
Sump Pump:
_Y_N
I ,
PLUMBING CONTRACTOR:--------.__
I . I
Po"" I E ,'-~_I...-4:'1
Plumber's Indiana State License #:
c:.P~IOI ,..,,\
__ Jl0/
Which plumbing codes will be applied to the construction:
1;i( International 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 0 BASEMENT (WALKOUT:_Y_N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction corrunences within 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 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 Carmel Indiana - 1993" (Z'
289) and amendments, adopted under authority of I.e 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
occup-m bee~ i,,~ed by tbe epartment of Corrununity Sm'j::s;;~~~a ~II i bQUJ h Ip 12!l(O 7
Signature of Owner or Authorized Agent Print 5 Date
OFFICEUSEONLY:******************************~**********************!**~**~O******************
INSPECTIONS REQUIRED: Filing Fees: (_6 . J
. . Base Inspections: / /.s. 00
Upper Footmg Lower Footmg Under Slab . V
C'</" ~
~ ~ Cert. of Occupancy: rJ :", - ~
CROU9h~ Meter Base'-...!inal Site
_ . _ P.R.I.F.:
7-Z~o7
S:Permits/Forms/IlP RESIDENTIAL
# Charged Re-
ReVIews
Additional Fees
# 30/ 00
(Date)
~~~
Fee Recelved by:
Date