HomeMy WebLinkAbout07080071 Application
City of Carmel/Clay Township Permit #: () 70 '30071
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
FAX:
6"1S-2\(P\
PHONE:
INC-
NAME:
\:::''(\A.(J) G,u;\,\, ht\ ht\ \ e\S
BUILDER
OF
RECORD:
9'ls.
GJS
STATE:
N
ZIP:
r. S6
BEST METHOD:OFCONTACT: - - -
Sc~'<9llirl(gin~L\l ~11:~%\;
11~~1 FAX: ill III
I~ U/ Sf ZIP IUlII
5 ON: ZONING' I
( lW~~l2-A'" I ~ VlD,J
SQUARE ~
FOOTAGE:..;? , , 'Y'
~\"(.ee~
PHONE:
NAME:
PROPERTY
OWNER:
l.;U::'
CITY:
STREET ADDRESS:
<?<rW\e
SUBDIVISION NAME:
lOT #:
i~e
LOCATION
&. PROJECT
INFO:
ADDRESS OF CQNSTRucnON:
'2 ~s 1'1f '7r. ,J VJ
ESTIMATED COST OF CONSTRUC110N:
(EXCLUDING LAND VALUE) "1> \ "2 0 I ()C, CJ
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZAI BPW DOCKET ,lu~\\S e)(CcNcch~q flAP Qe-=nJl. OockLl-
NUMBERS; TAC DATE(S); ANDIOR COUN1'I WELL ANOIOR SEPTIC PERMIT #'S (IF APPUCAB ): D {' I AI-OS"; b 4;0' Dt.;2,& () 4- 01062.:::>'2
1-0 TAX MAP PARCEL #: i.& "'C.C\ -L.S-6~L-6-; -OL..u. ~ ~l~
o1{J3(JOU! Iv -,-,"I "1.<;-O'2.'D-;'-O'''\-O)U
WATER UTILITY
PROVIDER: Co.. V \'\(\.-0\
SEWER lJTIUTY
PROVIDER: Co.. \( 'N\0 \
FLOOD ZONE AREA OESIGNATION(S)
FOR THIS PROPERTY:
"y... I'
"hvuz
PLUMBING CONTRACTOR:
, '
(L "0\2., ~ \\1\ W\ 0\ \1'..-3
Plumber's Indiana State License #:
C. {' crli\ <(', 00 \ hS
TYPE OF IMPROVEMENT:
,j NEW STRUCTURE
15 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 DEMOLmON
TYPE OF CONSTRUCTION:
SINGLE FAMILY
TOWN HOME
TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
~
o
~h plumbing codes will be applied to the construction:
)Ll International Residential Code w {Indiana Amendments
o Uniform Plumbing Code w{Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
~r:,,~~~ure~EL~EDrf,?R CO~~~'CJO'1'\~
Subject to~pliance with alllHlg~ACE 0 POST & BEAM _PIER
Sump Pump: ~t-Sffitll and Local CO "SLAB 0 BASEMENT (WALKOlJT:_V_N )
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_V-4N
_V -"'-N
I
For Single Family and Two Family dwellings. additions, el . or accessory sPJ.l..CfuK.e...~1 ~MDonly if construction commences within 180
days of the date of issuance of the building pennit, anO\~Gfffi9Aat(0ttillicfa~l:u~a'm:J Ys'sl'1l!d} U1thin 18 months of the issuance date. Class I
structure permits are subject to the General Adrninistr~tlve Rules of the St.ate flt'JYW~Jife 675 lAC 12) regarding expiration time frames for beginning and
completmg ~bl~ctlon.
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 Cannel Indiana - 1993" (Z-
289) and amendments, adopted under authority of I.C 36~7 et seq, General Assembly of the State of Indiana, and 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
Occupancyh JJuedby'~eDl~'me OfCOmmUni'YServic""c"""4:anatv1, A{~U oe'lfJ'z,!"
or Authorized Agent Print Date
OFFICE USE ONLY: ****** ********************** * *************************************** *************
INSPECTIONS REQUIRED: Filing Fees: 6 ;;< 7. (J CJ
(!lPpe~oting Lower Footing ~b Base Inspections: ;< ~ 50
~ ~I.. Cert.ofOccupancy: ' CO
~ In _ ~ase l"inal ~ ~ ~_J 07. .1 ~ I
/ /tI /J / P.R,I.F.: I~I~ lle-YIO~..!1
It/ ~ t.d'JI (Date) .~/J '~'~L:~:2. "J O. 0 ()
Reviewed/Approved: Dept of Community Services _~ .d~ ~
S:PermitsfFormsfIlP RESIDENTIAL Fee Received : Date
# Charged Re-
Reviews
Additional Fees