HomeMy WebLinkAbout07080247 ApplicationCity of Carmel/Clay Township Permit #: l
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
`.rxetaxa.% For Single Family, Town F?pme,:8? Two Familtr:.le>uv 1 tw clitions, Remodels, & Accessory Structures
cc"
ta- ; _3 r I -1 L)
BUILDER NAME: is ,on, :=nn vat a gopu a I ns Fax:
;;;a,
317
- 8
OF
RECORD' STREET ADDRESS: STATE:
r ZIP :
V
ucl5o FC f3 1 LX
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
s ND
PROPERTY NAME. PHONE:
X3
' 3q1 FAX:
7
i 7
3t 3 3y
-'7318
OWNER: DREES M S 1 _
.
STREET ADDRESS: CITY: STATE: ZIP :
7 RI E Sw -1' N P ICJ 10 8
LOCATION LOT SUBDIVISION NAME: SECTION: ZONING:
5
& PROJECT 11 L KESi h R ES E5 -
INFO: +A?DDRESS OF CONSTRUCTION:
o
U PARK bR VE
IlJOPq SQUARE
FOOTAGE:
/
Il?S
SEWER UTILITY WATER L1iLTY
" ESTIMATED COST OF CON UCTION:
EXCLUDING LAND VALUE)
fS
PROVIDER: /` A TD $ /I PROVIDER:
?R (
29 co
l1llC?
NAME OF Ur1LTrY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
'
NUMBERS; TAC DATE (S); AND/OR COUNTY WELL AND/OR SEPTIC PERMrT #
S (IF APPLICABLE): 3D C C
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL #: (`
FOR THIS PROPERTY :
TYPE OF CONSTRUCTION:
? SINGLE FAMILY
G TOWN HOME
? TWO FAMILY
# of units being
constructed at this
time:
(KRESIDENTIAL(For
Additions, Remodels, Etc.l
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
Y_5/
_Y! N
TYPE OF IMPROVEMENT:
NEW STRUCTURE
? ROOM ADDITION(S)
? PORCH ADDITION(S)
?/DECK ADDITION(S)
01 lV' BDEL
Basemen[ Finish only
? ACCESSORY BUILDING
? DETACHED GARAGE
? ATTACHED GARAGE
D DEMOLITION
Manufactured
Trusses: Y _N
Sump Pump: V7Y N
PLUMBING CO TRACTCK I AU6 10 X007 I, ?)
0J
L 1
u -T
Plumber's Indiana State L .;--
101777
WWhii plumbing codes will be applied to the construction:
U Intemational l Residential Code w/Indiana Amendments
O Uniform Plumbing Code w/Indiana Amendment,
FOUNDATION TYPE: (Check all that apply for the new
construction area)
O CRAWLSPACCE ? POST & _ BEAM -/PIER
O SLAB BASEMENT (WALKOUT:_Y ? N )
For Single Family and Two Family civ-ellings, additions, remodels, and/or atcessorystruccures, 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) within 18 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.
1, the undersigned, agree that any constructie5, reconstruction, enlargement, relocation, or alterationof a structure, or any change in the use c' land or structures
requested by cats application will comply with, and conform to, A applicable laws of the State of Indiana, and the "Zoning Ordinance of Camel Indiana - 1993" (2-
289) and amendments, adopted under autho-Av of I.C. 36.7 a seq, Gene=al Assembly of the State of Indiana, and all Acts amendatory thereto. I further tetchy that only
kitchen, bath, and floc-drains are connected to the sascaty sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupmeyhm bem iss Iued by the Department of Community Seniees, Carmel, Indiana I'
L^)Q•&n?lMano-?PmLfM2 1.oR1 A ?1Rb5yAlG-/YEAIIINE A
Signature of owner or Audtorized t Print Date
OFFICE USE ONLY: **ssxssssa:*xxsssssssxx*ss. .::. ---------------
INSPECTIONS REQUIRED: Filing Fees:
Upper Footing Lower Footing Under Slab
Rough I Meter Base Final Si
Revi /Approved: ommunity services (Date)
S:=5m FOrm?1LP RES ENTIAL
Base Inspections:
Cert. of Occupancy:
P.R.I.F.:
ZZ 00 # Charged Re-
Reviews
sS- s?
Additonal Fees
TOTAL:
Dv:
3o2 ro
Date