HomeMy WebLinkAbout07080209 ApplicationCity of Carmel/Clay Township Permit #: 100
I,
WO) RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
MO Rp?" For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME.
?
/ PHONE:
?
? FAX::
OF CcIA
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RECORD: STREET ADDRESS: CITY:
' STATE
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BUILDE_R5_SEMAIL AO RESS-//? -
_- -- --BEST D CONTACT:
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PROPERTY NAME: PHONE: _
?F x
OWNER:
1
STREET ADDRESS: )
CRY:
LOCATION LOT »: I SU.DIVIS N NAME:
3 ? SECT] ON:
11 S 076NING:
&PROJECT A- s
INFO: ADDRESS OF CON .SED, FOR CONS T RI LL ION SQUARE: IJ
'f t'
SEWER UTILITY
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PROVIDER: C -)' WAR _UTiJ•'r?YSndI I OCal Codes.
0 ESTIMATED COST OF CONSTRUCTION:
t1
o
EXCLUDING LAND VALUE) 3 L
x fti,
% c Q.
(a
/r
VATION
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NAME OF UMBERS TAC DATE(S
NM7ELL ANDjOR SE FRMff S F APPU
OR COUP
AND SYNSHIP
);
)
N
it irn nl
FLOOD ZONE AREA DESIG ATION(s).O n
FOR THIS PROPERTY: ? I n
N
No
MAP PARCEL »:
a??p
A
TYPE OF CONSTRUAON:
UK'SINGLE FAMILY
? TOWN HOME
? TWO FAMILY
2# of units being
constructed at this
time:
? RESIDENTIAL (For
Additions, Remodels. Etc.)
PRO)ECT INFORMATION:
Early Release
Permit: Y J
_
Lot Split: / Y V N
TYPE OF IMPROVEMENT:
C?NEW STRUCTURE
? ROOM ADDITION(S)
? PORCH ADDITION(S)
? DECK ADDITION(S)
D REMODEL
_ Basement Finish only
? ACCESSORY BUILDING
_- DETACHED GARAGE
D ATTACHED GARAGE
? DEMOLITION
Manufactured
Trusses:
Sump Pump:
Y .-s4N
Xd
?Y_N
PL MBIf G CONTRACTOR: `Ica, ~?(pp/Tt9?8.yqQ,?/???
Phi ber's Indiana Sta e '
Which plumbing codes will be applied to the construction:.
I?temational Residential Code w/Indiana Amendments
O Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
O CRAWLSPACE ? POST & _ BEAM -PIER
O SLAB CAB SEMENT (WALKOUT:_Y _??fJ )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences within 180
days of the date of issuance of the building permit, and must be completed (Certificate of occupancy issued) wgthm IS months of the issuance date. Class I
structure permits 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. tecpns[aiction; enlugemen[, relocation or alteration of a structure, or any change is the use of land or structures;
requested by this application will comply ij confoan to, all applicabfedaws of the State of Indiana, and the °Zcning Ordinance of Carmel Indiana -1993" (Z-
289) and amendments, adopted under ority 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 Boor dmirs are c nee[ed to the sanitary sewer. I further certify at the construction will not be used or occupied until a Cera "te of
Occupmeyhas been issued b th Department ommuniryServices, CCaarmel, In 'ana.
Sip - re of Owner w Authwrs a Print Date
OFFICE USE ONLY: ************
c___KOU9m+n
Filing Fees:
Base Inspections:
Cert. of Occupancy:
P.R.I.F.:
Y?***?k#***,kii*:t*rK**
7 5() # Charged Re-
Reviews
s (f
GlJ Additional Fees
?2_?R rj/l-
Reviewed/Approved: Dept. of Community Services (Date)
s:P i1slioans;I PRESIDEIMAL