HomeMy WebLinkAbout07060276 Application
. City of Carmell Clay Township Permit #:-07 CipV:J.,7 (p
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:
NA~\\\leA\"c~ \\u"""e';::.
STREET ADDRESS:
Gl..lloLD ~.,/~ 'Si.-40i:>
BUILDER'S EMAIl ADDR~SS:
d"", t-c.c.".).;\ ;,::,,:, ,\Vtr\\,"'-r ~ \-'.....--u ,C "''''"'
NAME:.- . PHONE:
c:;;., \ v.....+"'-()~~ \-\:<""'-l-S 4?,'i'J- \ 81 <;'"
STREET ADDRESS:
(g191919 C.
lOT #:
'u
/'S~
0:::.
SUBDIVISION NAME:
\:, .,.cl~-f...-
ADDRESS OF CONSTRUCTION:
l.--c.'^-'l..
Cc.r
SEWER UTILITY f"'t.-r-
PROVIDER: L-- \ K W~
WATER UTILITY C' . ~
PROVIDER: . c.. V" v--.lL1l
PHONE:
<g<j .i~(S"
FAX:
~4d'<6d~
CITY:
ZIP:
"(f.p'E) .
s_
STATE:
:P\J.
BEST METHOD OF CONTACT:
e"",,,,-; )
FAX:
-&;ll.,~
CITY:
-;e..,.
STAlE:
:::r-.-v -
ZIP:
I..{(.,'J
ZONING: J
"::,-
's.
SECTION:
-r.v, 1./100::"
SQUARE
FCOTAGE: S'1 L\ l
ESTIMATED COST OF CONSTRUcrrON:...,"I
(EXCLUDING LAND VALUE) c::J (/ S
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / 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:
d SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
TYPE OF IMPROVEMENT:
fjJ 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
W;\Sc", ~~fI{0"k~~:;-:-;-:-:
TAX MAP PARCEL #; lijEO 7tJiObJJ;7
J I '-/. I
I' _ <
PLUMBING CONTRACTOR:: I i JUN 2 8 2007
- 'II I '
.J\\~ e.. 0__ \ ..-)"-~ OJ's
Plumber's Indiana State License #:
'3\ to(" 4 'Q 4-0 L
I
-I" II
'I I'
': Iii
iJ'~.) jf
10
i
Which plumbing codes will be applied to the construction:
~temational Residential Code wjlndiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Early Release / Manufactured
Permit: Y N Trusses: Ly _N 0 CRAWLSPACE 0 POST & BEAM PIER
Lot Split: Y ./ N Sump Pump: ../-Y _N RELEASgJ flkt~ wi h ~~~81/fiir Y~N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structuretOtlffitl~tftmlns.1vl.:Ioou:ilf'~aaruction commences within 180
days of the date of issuance of the building pennit, and must be completed (certif:M~I1.'i3cpf~~:I~ ~trpr~ptbJ?iGance date. Class 1
structure pennits are subject to the General Administrative Rules of the State of IncltMm (S~e 't'i1.t; LtC'11 J JJodlng e~pifat11ih bme lluor beginning and
completingco~oOF CARME / CLAY TOWN It"
1, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a strul~~ pn."'RY}i,hange 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 h~ "'lbhttJ.~Ordinance of Cannel 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 ar connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupan has heet)ued h Department of Community se~ C~ndianz.\\ ~! (r8- ?? ..r:s;
Igna of wn or Autho . printC') '~ ". il_,. l ~e_,\ Date
OFFICEUSEONLY:****************************************************~,,~*************************
_~PECTIONS REQUIRED: Filing Fees: tf-r ~ :; 0
r-:::ppe-r Footi~9 er 00 Ing der Slab Base Inspections: J J /. ~
Cert. of Occupancy: ') ,) - ___
-
P.R.I.F.: ~~oo ^'"',,",,-
T. T _# s?- ')?J.. ~ If
A
Site
I
Dept. of Community Services
5:Permlts/Fonns{IlP RESIDENTIAL
# Charged Re-
ReViews
Fee Received by:
Date