HomeMy WebLinkAbout07070206 Application
City of Carmel/Clay Township Permit #:07070:;t1o
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
,
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME: Qf L,,-J1. /JJ /L PHONE: f1u-}/od FAX:
OF t.J LIP
RECORD: STREET ADDRESS: 7;-':)- STATE: ZIP:
.~~ 1/(,0 ~.. "z..
., ,
BUILDER'S EMAIL ADDRESS: QJ -'I!
YY\ Oil _5;
PROPERTY NAME: 1 ,
Y i ,iUL ?~J7 'Ii
OWNER: [, f . ~
STREET ADDRESS: .,-..rr; ITY: IU STATE: ZIPJ 1..--,' I
~..."-..:.,rv.ED
LOCATION LOT #: a01 LSECTION: . ZONING: . .___-.J
& PROJECT Ja J tlJ /C(JCr'">
INFO: ADDRESS OF CONSTRUCTION:
SEWER UTIUTY
PROVIDER: l'T/l w t?
WATER UTILITY /"
PROVIDER: C c.... ^ ~ c: r
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / 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:
if SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions, Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
_Y/N
_Y~
Lot Split:
Rough In
c
~
TYPE OF IMPROVEMENT:
~~ STRUCTURE
o ROOM ADDmON(S)
o PORCH AODmON(S)
o DECK AODmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACH EO GARAGE
o ATTACHED GARAGE
o DEMOUTION
Manufactured
Trusses:
Y~
~N
FOUNDATION TYPE: (Check all that apAlMr the new
construction area) '!:Jc:.\V~;Q
~WLSPA~;. eo~1\\llil\)\&itM _PIER
~LAB ~aJlS~~~e~~~~
For Single Family and Two Family dwellings. additions, remodels, and/or accessory structurea.~ ..~ \".: _ ~::~i - ~ es within 180
days of the date of issuance of the building permit, and must be completed (Certificate of OcQ.'D~u~_!l~~~~ari~e date. CI~s I
structure permits are subject to the General Administrative Rules of the State of Indiana (See ~t 12)~; .tif~frames for beginning and
completing construction. U'{ -- . !,".- ~ .
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration ~~~UP:' (!.,Sh~ ~~se oEland or structures
requested by this application will comply with, and conform to, all applicable laws of the State of Indian~ tGlZoning Ord~i~e of Cannel Indiana - 1993~ (Z~
289) and amendments, adopted under authority of l.c. 36~7 et seq, General Assembly of the State of In~ .'a d 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 issue y the Department of Community Services, Carmel, Indiana.
/ ~ _ (/? I {./lnA
Sjg~ture of Owner or Authorized gent Print
OFFICE USE ONLY: ********* ** ******** ** *********~~*******************?* t*2************ ***********
INSPECTIONS REQUIRED: FIling Fees: ,LJ _ 1rJ
r ..' . Base Inspections: d- J>7- fd
~per Footing ower FootIng nder Slab ...-J}
'< ----, Cert. of Occupancy: ,,;f . ) 1/
Final Site / / ) ,,-- / iii) .
_______________ P.R.I.F.: . if lo (. UIJ Addition~1 Fees
I ~-l-o .: /J #~?b.-;;70
oved: Dept. of Community Services (Date) ~ {
S;PermltsfFormsfILP RESIDENTIAL
Sump Pump:
Fee Received by:
TAX MAP PARCEL #:
PLUMBING CONTRACTOR:
5cl, I.. /...< flu",- 6':-1
Plumber's Indiana State License #:
C ;0 y/ 0"><,-3 {,5-
Which plumbing codes will be applied to the construction:
G1'ntemational Residential Code w/Indian~"~mendments
o Uniform Plumbing Code w/lndiana Amendments
-'<'('#1.1.
./
7- }'cl-i} 7
Date
# Charged Re-
ReVIews
Date