HomeMy WebLinkAbout07080066 Application
City of Carmel/Clay Township Permit #: () 709lf)vl.J2
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
I
,
I
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER lITIlITY
PROVIDER:
t~: (Q GlA \AST-rCA(bl;\; ld1'vc". 1 ;:joe:
'2A.S -.<olOC\<;
FAX:
gqS;-ZllRI
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STATE:
ZIP;
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CITY:
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BEsT;METH6~OF'CONTAd: U \? LSJi \ \ \
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PHONES" mJ I AUG -: I Cfoo 111 Jil
I U wi STATE:_---.J 'ZIP' I
---'
ZON1NG:p 1ft. D
SQUARE 17 .it Ca/
FOOTAGE: fi 1~J( I; .;'t'
,
ESTIMATED COST OF CONSTRUCTION;
(EXCLUDING LAND VALUE) :!p \ LO , DO() ')
;,\S ~....",'-h "'~ "wp ~w POCI::lT',;I
of' A \..D <;.;>- 0'\.::1 co'b& 0 <\-0. co3S2
TAX MAP PARCEL #: IW-Cl"\ -1.S-'<), ..o~.. D'l." <'GO
'iP -<PI . '2.<; -':L''':; '6", I "CC>
NAME:
N\t100VI. ',,-
M4111\
I....LG
CITY:
STREET ADDRESS:
S"l~
LOT#: i35
i...- -EC'nON:
'/i.l.)O
SUBDIVISION NAME:
DA
ADDRESS OF CONSTRUCTION:
'2-11 I~ 51. ).1 vu
Co.. '( \'V\e \
WATER LJTILITY
PROVIDER:
L(a\ Me, \
NAME OF UTILITY EXCAVATION CONTRACroR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICAB
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY;
TYPE OF CONSTRUCTION:
2; SINGLEFAMIL Y
'1' TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
vX' N
Y~
~ V\..Q
..... ~ jl
TYPE OF m.~S~~r0R COtl1~~~TRACTOR:
,r25... NEWi~Rl!lmpliance with all ~I<llonsP\V\ Vv\ b\ ~~
o ROOM ADD~ffil, and LocaPJUCIlleg. Indiana State License #:
:s ~~~~~~MMUNITYSE~~~PJ~OO \3>S
o ReI~OF CA8MEL / C~ciT~W~Will be applied to the construction:
Basement Finish ~1j1~ i'~_
o ACCESSORY BUILDIN6' IAN~ntemational Residential Code wi Indiana Amendments
o DETACHED GARAGE ., .
o ATTACHED GARAGE 0 UnIform Plumbing Code w/Indlana Amendments
o DEMOUTION
Manufactured
Trusses:
Sump Pump:
FOUNDATION TYPE: (Check all that apply for the new
construction area)
D< Y _N
_Y~N
o CRAWLSPACE 0 POST & BEAM _PIER
~ SLAB 0 BASEMENT (WALKOUT:_Y_N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences wit~ 180
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. 9ass I
structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana - 1993n (Z~
289) and amendments, adopted under authority of l.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen. bath ;mp float drains are connfo the sonita')' ,.wer. I further ce<lily that the con"ruction will not be med m occupied until a Ceralicare of
Occupanc as bell issued by thi?jP ent of Community Services, Carme;, Indiana.
, tr 1M.. VV\ . t.j:Prt M, Mo?~ af/o1-IO'
Signature of OWner or Authorized Agent Print Date \. .
OFFICE USE ONLY: *************************** * ****** **** ****** ******* ~ *********** ****************
INSPECTIONS REQUIRED: Filing Fees: :::L [) 0 . to 0
~ =- . .r-=-' Base Inspections: '1. en "1 J c~O # Charged Re-
I.. Upper FooWlg Lower Footing 1.1!.n'(Ier :'I~ V I. { S ReViews
~ Cert. of Occupancy: ,iJS , 0
~ ,-1iIe'teHlase Final . e ",,/
~. ~ P.R.I.F.: w--o Additional Fees
IV~ ~. 97.3,
Reviewed/Approved: Dept. of Community Services (Date)
S:Permits/formsjllP RESIDENTIAL
Date