HomeMy WebLinkAbout07060277 Application
\ City of Carmel/Clay Township permit#:~1Q
! 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 lJTILTIY
PROVIDER:
NAME:
O~",-~......irvlle...
PHONE: 011,) 't7:; -~2.I"
FAX: 0/i.
STREET ADDRESS:
/()?C;J.. W",S-t'ovL tJl'.
BUILDER'S EMAIL ADDRESS:
d. J-b,..'.....(1e.8 ea./'-fA/:"/(. h~-f
NAME:
CITY:
La.."",,,,....tt:.1
STATE:
:D/
ZIP:
?(c~:J::1..
,2"".<,,- (:JIll '17 J - ~ 2. 'S::
BEST METHOD OF CONTACT:
PHONE: ,_~ .0,,-1.
(3tl/,,/-7
FAX: ,(//4
(Jet-pi<) "" 13 r.'" Ie.
STREET ADDRESS: /l
/61 ?C?- f/./e.7I-ovL vr,
LOT#: '-5'
CITY:
c:.a/.__,,-I
STATE: . /
]:..JV
ZIP:
"-/? o-;J 2-
SUBDIVISION NAME:
rlk P<W'/( fi?i<J,z .
ADDRESS OF CONSTRUCTION:
(1/7,;
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
C-.cl.o/I--d
TYPE OF CONSTRUCTION:
eM
o
o
SINGLE FAMILY
TOWN HOME
TWO FAMILY
# of units being
constructed at this
time:
o RESlOENTlAL (For
Additions. Remodels. Etc.)
Early Release
Permit:
PROJECT INFORMATION:
_Y )<IN
_Y~N
S:Permits/FormslILP RESIDENTIAL
Cav-.el L1/ 'IC'cn z..
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LANO VALUE) 1'1<(,000,0"
NAME OF UTILITY EXCAVATION CONTRAGOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE):
Lot Split:
/JIll<
,VIA f!';~-'i~~~ ((~-~~';-f ',,",
1\; II '- ---..-
TAX' MAPiPARCEL- # ;__u_
Ii L)/ I
PLUMBINGIOONTRAcmR:2.
.ttI/,{ I U 1I1
Plumber's In'dlana State License #:
I
TYPE OF IMPROVEMENT:
2007
:..'ill
II( 'I,
III I;,
1'\ Iii
.Jl~1
I
NEW STRUCTURE
ROOM ADDITION(S)
PORCH ADDITION(S)
DECK ADDITION(S)
REMOOEL
_ Basement Finish only
o ACCESSORY BUILOlNG
o OETACHED GARAGE
o ATTACHED GARAGE
o OEMOUTION
o
.a:
o
o
o
Which plumbing codes will be applied to the construction:
o
o
International Residential Code w/lndiana Amendments
Uniform Plumbing Code wfIndiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Manufactured
Trusses:
Sump Pump:
_Y...2LN
_Y~N
o CRAWLSPACE
~ SLAB
o POST &
BEAM _PIER
o BASEMENT (WALKOUT:_Y_N)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences vvithin ISO
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. 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 Jaws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana - 1993~ (2-
289) and amendments, adopted under authority of l.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
Occupancy has been issued by the Department of Community Services, Cannel, Indiana.
iJAftW'^ !3../ J ~
c;/Z7/~ 7
,6)~fr1...~~
Signature of OWner or Authorized Agent
Print
Date
OFFICEUSEONLY:************************************************************J *******************
INSPECTIONS REQUIRED: Filing Fees: /~ d--. ()~
Base Inspections: ~3 O.
Lower Footi n
Cert. of Occupancy: 5S. ')'()
# Charged Re.
Reviews
P.R.I.F.:
Additional Fees
~~1-(}7
(Date)
P.y3f~
' ~/07
Date
~
Fee R by: '