HomeMy WebLinkAbout07080091 Application
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
I
City of Carmel/Clay Township Permit #: t)7()~190g I
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
PHONE: FAX:
S75 .J350 j ,J-O (:,
STATE:
C /-\--KME:-L ;J
[- CWYl . S
\ \ CO -(2./ (], A-rJ
BUILDER.'SEMAILADDRESS'S "p C-.i) _ (;\ P . ~ BEST METHOD OF CpNTACT:
~OANrJE. HEc l1u<:_D ~ U,L-l t.t-Om t:D1AIL
ZIP:
CITY:
J,
3a-
NAME:
PHONE:
FAX:
.s AI Y\(.
STREET ADDRESS:
CITY:
STATE:
ZIP:
LOT#:
i4ftDIVISIOV NAME: SECTION: ?.l ~
UWN MOr\1ES AT 6 ell L fOI2/J J..P
ZONING:
S-l
SQUARE _
FOOTAGE: J.5 73
SEWER LJT1LITf'.' '\.
PROVIDER: L-L/-\'-
WATER UTI
PROVIDER:
NAME OF UTIliTY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / B DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SE C PERMIT #'5 (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
o /SINGLE FAMILY
~ TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
A -l-SLtPER-LO/:( t:-"c-
TAX MAP PARCEL #:
- - Q-3<o-0303 - OCfO, 000
TYPE OF I Ettrle andnce CTOR:
~eG/Si'Rmu~E COMM!/cal Co/sgU Ij n 'l-SD ~
o ROOM ADDtrI9N{~ME:1 N ndiana State License #:
o PORCH ADDITION(S} '- / ClA)'
o DECKADDITION(S}IND/"..
o REMODEL ,." "/1
Basement Finish 0
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
x
SUbject t~;D FOR C
~ntemational Residential Code wI Indiana Amendments
o Unifonn Plumbing Code w/Indiana Amendments
_Y VN
YvN
Manufactured
Trusses:
Sump Pump:
FOUNDATION TYPE: (Check all that apply for the new
construction area)
PROJECT INFORMATION:
Early Release
Permit:
o POST &
Lot Split:
v- Y _N
V'YN
o ,,9lAWLSPACE
U SLAB
BEAM _PIER
N)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is vali
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy issued) wi
structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regard
completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or y c ange in the use of land or stru ures
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and th~ "Zoni Ordinance of Carmel Indiana -19 3~ (Z~
289) and amendments, adopted under authority of J_e. 36~7 et seq, General Assembly of the State of Indiana, and all Acts that only
kitchen, bath, and floor drains are connected to the sanitary sewer. 1 further certify that the construction will not be used or occupied until a Certificate of
oeQ'has bee\;:u:~ h t)>e Departme~tornmunity Semees, :\DA~~ E S H-EP HERD g{ 1J 0:1
Signature of\ ner or Authorized Agent Print - Date
\
OFFICE.US ONLY:******************************~~*******************~*~***~*Ci*****************
PECnONS REQUIRED: FIling Fees: -01-
. . Base Inspections: c2.. 87- '>0 # Charged Re-
Upper Foot, g Lower Footing Under Sla ReViews
Cert, of Occupancy: S- 5 5"0
P,RJ,F,: / ,) (, /. (j 0 Additional Fees
'{;.
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