HomeMy WebLinkAbout07080075 Application
City of Carmel! Clay Township Permit #: Ol 08 DO 7 S-
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
NAMj:>()"L It:
W5~mSStv rYl ER I DI A J
PROPERTY
OWNER:
NAME:
BUILDER'S EMAIL ADDRESS:
.Jt0 hnne.-S:t+
E
STREET ADDRESS:
LOCATION
& PROJECT
INFO:
L~(q
SEWER LmLJR "
PROVIDER LPitfY\ d--
WATER UTILITY
PROVIDER: CAf2-()lGL
PHONE: FAX:
5-75 ,;l3S0 ;( d-00
STATE:
CIJ..:'f2.tvl EL t ,....)
P BEST METHOD OF CONTACT:
LALTG - ~[)yn. EmA lG
CITY:
ZIP:
4-bo3J-
PHONE:
FAX:
cm:
STATE:
ZIP:
S~IY
ZONI~: _ "1
SQUARE c:. Q-J Q
FOOTAGE: ~ ' I
08 /
A - 1 -SUPf,-eJ OL E: XC.
ESTIMATED COST OF CONSTRUCTION: I X'. I I
(EXCLUDING LAND VALUE) 0 L.....J- t
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 APPUCABLE):
@-NEW STRUCTURE
o ROOM ADDITION(S.
o PORCH ADDITION(S,
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
PROJECT INFORMATION: 0 DEMOLITION ~NDATION TYPE: (Check all that apply for the new
Early Release v<:' Manufactured ~C~ ,~uction area)
Permit: _Y _N Trusses: t.-y ~I!?~~ erov\7>~ CRAWLSPACE 0 POST & BEAM _PIER
./ I ,,}(P\~: ~\ \
Lot Split: _Y~ Sump Pump: ~_~'l\~o6e"'~\Ci SEMENT(WALKOUT:_Y , Il)
FOrSingleFamilyandTWOFarnilYdWellingS~add' .~tQ .~".' ,,~~qi~s ,thispenni 0 lffia'n enceswithinlBO
days of the date of issuance of the building _'.,~01.~... ~e:&\Pi~~~t;:~~at ofOccupancyiss within S/,f;;,n s h eclatf':. Class I
structure permits are subject to the General ~f't\.t~ca ~~""'~~t. @.Ifiaian: (See 675 lAC 12 diJ!.g ~xpiration t" e r beginning and
S 0~; cOl\lkuctwn. f-.luG 1 n
I, the undersigned, agree that any construction, reco~st oOe. ~~~, or alteration of a stw ture, or any chang~rJ(J{Jooe of or structures
requested by this application WIll comply with, and _ ~l _ p icab~~s' of the State of Indiana, an "Zoning Ordinance ~fCarm iana - 1993" (2-
289) and amendments, adopted under authority of I. . ~ eU~q, S'e.neral Assembly of the State of Indiana, amendatory thereto. er certify that only
kitchen, bath, and floor drains are connected to the s€it~rY sewer. I further certify that the construction will not De u ied until a ertilicate of
oc:upanCYhaSbeen,,"u by the De art",it]lcnmmUnityservices.c:t(;MtJE -S I+6Pi--\~() [(I/YOI 01
~gnatu wner Of" AuthOl"ized Ag t Print Date
\
OF
EONLY:******************************~*******~****************J7~**********************
INSPECTIONS REQUIRED: Filing Fees. 0/, -L.- /j)
~er FootinD LG:er~ Under Slab Base Inspections: c-2-;r? .)~~
e ~ Cert. of Occupancy: SS - :J
~69hIn ~e~ mal Si~ /2 (;!. (JO Addltlona!Fees
_ _ P.R.I.F.: _
0~!Iy~9/90 .
Fee Received by: y
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
CD/SiNGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
I(
Xl'
en oB 001
TYPE OF IMPROVEMENT'
G~~.8.;IIc;.~ !!> -1A::ol
Reviewed/Approved: Dept. of Community Services (Date)
S:PermltsfFormsfILP RESIDENTIAL
TAX MAP PARCEL #:
II - I 0 .2-2- - 00 - 2.S . 05 ~ . 000
PLUMBING CONTRACTOR: . \
K-A-vY'I VVl ~ ~O,vS. I N(.
Ilumber's Indiana State License #:
L PI 000 (0 \
Which plumbing codes will be applied to the construction:
~temational Residential Code wjIndiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
# Charged Re-
ReVIews
{
~
Date