HomeMy WebLinkAbout07080005 Application
City of Carmel/Clay Township Permit #:D7D8f:[f)5
~~n~~~~,~ ~~?v.~~~!:~~~~l,~~ru:-p~I~~~~
Sub'eet to eompliilnc" wilh ,,111"pulallons
BUILDER NAME' (' I ' _ of Slate cOld I 1)[fl\leOd!s, _
OF, .-/ 1I0a o'efl:f0- ,\ !,MUI'J'TY ~,'I ViCES
RECORD:) STREETADDRESO--,.... CJTY OF CAiWi;T~S.cuwrlii..'PiNSi-.IIP
c/ L ~ .J",{ <! - .o~ N - MH~ ,~oz.~7.
BESTMrnoDoFlCoN+Aci~ !:~,.: 1:' \\:1' . .~:
,(0 iil )jr"::--:~=-~~'~-~ill \ I
111\~1 AUG -T'2D07 Iii m
'U UL STATE ZIP:! ~ I
)1
PROPERTY
OWNER:
NAME:
STREET ADDRESS:
LOCATION
& PROJECT
INFO:
LOT#:
2)
ADDRESS OF CONSTRUCTION:
SEWER UTILITY C
PROVIDER, 1/t W 0
(,
WATER UTILITY C
PROVIDER:
f7.../</><<:-
CnY,
ESTIMATED COST OF CQNSTRUcnON: ..-
(EXCLUDING LAND VALUE) 27) cJ 0 d,'!!.!L-
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY' WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATlON{S)
FOR THIS PROPERTY:
TYPE Of CONSTRUCTION:
~NGLE 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
Lot Split:
_Y_N
TYPE OF IMPROVEMENT:
~W 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 DEMOUTION
Manufactured
Trusses:
Sump Pump:
~~
fCCI#-
'.~ ",
?rfJ? O() 05-
Which plumbing codes will be applied to the construction:
C{J...Jm:Emational Reside,ntial Code wjlndiana Amendm!ents
o Uniform Plumbing Code wI Indiana Amendments
i
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM PIER
~LAB ~EMENT (WALKOUT,_Y=N)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences within ISO
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 permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
ompleting construction.
I, the undersigned, agree that any construction, reco ruetion, enlarge t, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this application will comply with, a confonn to, all applicab laws of the State of Indiana, and the "Zoning Ordinance of Cannel Indiana - 1993n '(Z'
289) and amendments, adopted under authori of I.c. 36~7 et seq, General sembly of the State of Indiana, and all Acts amendatory thereto. I further certify th:at only
kitchen, bath, and floor drains are connected 0 the sanitary seyv'er. ...~~rthe certify that the construction will not be used or occupied until a Certificate ofl
Occupancyhas been issued y the Depar ent of Commuriity StJ~ce/gel, Indiana.
-. ~ .I1L C {ar. c..:::- J ~ /-07
Sign pJ.{nt 'Date
***********************************************************
395' 6 (l
;J rP7 ,.5?)
. <So ')(J
.;2 6 o()
02
OFFICE USE ONLY: **************
Filing Fees:
Base Inspections:
Cert. of Occupancy:
UIRED:
Lower Footin Under Slab
~
S:Permits{Forms{ILP RESIDENTIAL
P.R.I.F.:
Fee Recei
# Charged Re-
Reviews
Additional Fees
/
(
()
Date