HomeMy WebLinkAbout07060227 Application
City of Carmel/Clay Township Permit#: 67000').:(1
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
. FAX:
X ;)Ofo
BUILDER
OF
RECORD:
/-to'h S
STREET ADDRESS:
\5Qo N mE:;R-({j'A~
BUILDER'S EMAIl ADDRESS:
-JDAN~5" SHEPHERD
5~1'V\G
STATE: ZIP:
EL L}.t.o03:J...
BEST METHOD OF CONTACT:
"com smA I u
PHONE: FAX:
NAME:
PROPERTY
OWNER:
ZIP:
CITY:
STATE:
STREET ADDRESS:
ZONING: S - ..1
SQUARE '2...QQ2-UN It
FOOTAGE:
LOCATION
& PROJECT
INFO:
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING lAND VALUE) 4-LJ. 2"1- LU\J II
'{IO, 5' /"bid
SuA-' lOR- 5K I
?r03 - OYJ 4: -00
WATER UTILITY
PROVIDER: CA-iLM EL
SEWER lITlLITY
PROVIDER:
NAME OF LJTILITY EXCAVATION CONTRAcrOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS: TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
A.
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TAX MAP "'~~~L #:
n -l'.A - iLr
PLUMBING CONTRACTOR:
C p [ 000 , 0 \
Plumber's [~t~enz #:s 0 N S
TYPE OF IMPROVEMENT:
IJVIiiEW STRUCTURE
D ROOM ADDITION(S)
D PORCH ADDITION(S)
D DECK ADDmON(S)
D REMODEL
Basement Finis"
D ACCESSORY BUll"
D DETACHED GAIU
D ATTACHED GARA
D DEMOUTION
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
G'YTOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
D RESIDENTIAL (For
Additions. Remodels. Etc.)
Which plumbing codes will be applied to the construction:
(J---rntemational Residential Code w IIndiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
f(vr
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE D POST & BEAM _PIER
CJl--SCAB 0 BASEMENT (WALKOLrr:_Y_N )
PROJECT INFORMATION:
;/
Y N
Y ~
Manufactured
Trusses:
Sump Pump:
Early Release
Permit:
L--"
_Y_N
-y-~
Lot Split:
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 (Certificate of Occupancy issued) within 18 months of the issuance date. pass I
structure pennits are subject to the General Administrative Ruk,~f the St,ate of Indian~ (See 675 lAC 12) r.cPD' ir C' tma~" ~d
t1tt~~~~nstructlOn., . ~L.
I, the undersigned, agree that any construction, reconstruction, eSu~ent, ~qn-A' ,alteration of a structu, a . s f n r r u~es
requested by this application will comply with, and conform to, all apP^'!!mflC~be.~e6rfi')1\~~and the "ZoningOtdin~n~e of Carmel Indiana -1993: (Z~
289) and amendments, ado~ted under authority of I.c. ~6~7 et,se~. Gen. eral4Jf~JY'~~!:f ortn~: ,~fg ~~endatory t~ereto. .1 further ::rtify t~at only
kitchen, bath, and floor drams are connected to the samtary se~lt~l)~~Con~liWrm 'tt'ol b:JtV. d or occupied until a Certificate of
Occupancyhasbeeniss edbytheDerartment1-Conun~es:~~~ a.OCa/c 9Ulation
./ f'lU1j) f:. .,,!~ etl?G:M G / dO/01
(5ignatur f Owner or Authorized A Print
\.
om
Date
$~**************************
/70 ") .;l0
c'). 17 SO
S'5S 0
J ;J. i!lj 0 Addibonal Fees
$' ,;? J {)?,. ~(J
/3
U5EONLY:**************************************
Filing Fees:
INSPECTIONS REQUIRED'
# Charged Re.
Reviews
Base Inspections:
Cert. of Occupancy:
P.R.I.F.:
(Date)
Reviewed/Approved: Dept. of Community ServIces
S:Permits!Forms!IlP RESIDENTIAL
Date