HomeMy WebLinkAbout07080061 Application
City of Carmel/Clay Township Permit #: 070<600t..e\
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, lk Two Family: New Structures, Additions, Remodels, lk Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
lk PROJECT
INFO:
SEWER UTILITY
PROVIDER:
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OI"'V VJ7 Ii V AJ~ fA/I IIh-(2{: /]:tJ[. :
CITY: STATE:
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B~;:~~~ADDRE~~ ~+v...bv;( &~, "" ""- j;Sf M~l~Tifr!ACT~" <+ '. n2:z-
NAME: PHONE: II i\ \ I FAX: I ! '
rVlo}.\o,.J 1 ;vU1,J U(}f2l..EASED FOR ~rlU(j.t\eJN- t.., -:2.007 Ii: .
>fREET ADDRESS: U Jec orffirnp lance w, !. 9 A I :' v ZIP:I L'::. ' :
Sa.M.2,. of State and LOC!!' Codes-:--...----J I
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STREET ADDRESS:
8'5~ ;;
LOT#:I'31i\
5:''iS' -q D"f5:'
FAX:
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ZIP:
Z?:P
SUBDIVISION NAME:
MDNO~ ..
S'f.
ADDRESS~. ONSTRUCTION:
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WATER UTlll1Y
PROVIDER:
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TAX MAP PARCEL #: II. - 0'1- '2-5".0"- '-"3 ~,,'J.<). ..-
,> - cCI- 'ZS'- c2- -"'1-"~ ,c.o <:>
SQUARE
FOOTAGE:
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
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
t,1(tIV\"-J.....
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
~o SINGLE FAMILY
TOWN HOME
TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
~~
N~
C,Af?,"""L-
-ZONe
i(k~'
61>8'o~(g
PLUMBING CONTRACTOR:
~~ PWi'^M "q
Plumber's Indiana State License #:
r:flafDDI5>
Which plumbing codes will be applied to the construction:
~ International Residential Code w IIndiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM _PIER
~SU\B 0 BASEMENT (WALKOUT:_Y_N )
--0 ( \ -/J- :cessory structures, this pennit is valid only if construction conunences within 180
\\ ~ (Certificate of Occupancy issued) within 18 months of the issuance'date. Class I
~<A \.t l te of Indian~ (See 675 lAC 12) regarding expiration time frames for beginning and
~ ~v 19con,rructlon.
location, or alteration of a structure, or any change in the use orland or structures
'-'s of the State of Indiana, and the "Zoning Ordinance of Cannel Indiana - 1993~ (Z,
/J ~ dr-- '~ObIYOfth'Stateoflodhoa,aodallAc"amendatmYthmto. Ifurth"mtifythatooly
'( '0./\ "iv' tify that the conmuction will not he u"d or occupied until a Certificareo!
01D~ 00 W\ ~a~, v.Ao;'~ Da~4Dz(V7
For Single Family and Two Famil:
days of the date of issuance of tl1
structure permits are subject to tl
OFFICEUSEONlY:****************************************************************2'***************
INSPECTlONC: ~EOUIRED: Filing Fees: tP ;;< 7 , CJ
~!l" '~under Slali Base Inspections: /Z <;;:( t-t. 50
~ -----.... Cert. of Occupancy: .5-5, .5'0
~. (Me~a~ Final Site I
VL ~ P.R.I.F.:
Reviewed/Approved: Dept. of Community Services (Date)
S:Permlts!FormsjILP RESIDENTIAL
TYPE OF IMPROVEMENT:
~NEW STRUCTURE
d ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
Manufactured .y
Trusses: ~y _N
Sump Pump: _Y ~
Fee Received b .
# Charged Re'
ReViews
Additional Fees
Date