HomeMy WebLinkAbout07080252 Application.?:j of C?qq.?, r/
City of Carmel/Clay Township Permit #: 7080 5 •
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
waraAa For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF NAME.
A" c Cln/ PHONE: FAX:
W6-<? gg$ S1I C1 Is3
RECORD: STREET ADDRESS:
I I 12 v 2?P L CITY: STATE: ZIP:
GA*ine_e /A/ '(160 33
BUILDERS EMAIL ADDRESS:
t4. Qo f_4tLrN BEST METHOD OF CONTACT: O /L
AOL . c-o /v( Fill; -aVFPl 710
PROPERTY NAME: PHONE: FAX:
OWNER:
STREET ADDRESS: CITY: STATE: ZIP:
I
LOCATION LOT #: SUBDIVISION NAME:
O SECTION: ZONING: J
& PROJECT .-
2 W ooe
IN FO: ADDRESS OF CONSTRUCTION:
nL'? A-
080
o SQUARE
FOOTAGE:
SEWER UTILITY
PROVIDER: ^ / A
A?hz? WATER UTILITY LAY
PROVIDER: ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) 100
I
NAME OF U ILAY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET '7 ('5 2 (0 'P ys3
'l
NUMBERS; TAC DATE(S);AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S(IF APPLICABLE): Al Glcoa(l-' / TIZA ess
eg-
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY: TAX MAP PARCEL #:
- 10 -3 -tr"-) •- 70 - OQ ?2. VtJ d
TYPE OF CONSTRUCTION:
4- SINGLE FAMILY
E:) TOWN HOME
? TWO FAMILY
# of units being
constructed at this
time:
? RESIDENTIAL (For
Additions, Remodels, Etc)
PROJECT INFORMATION:
Early Release
Permit: Y N
Lot Split: _Y :_N
TYPE OF IMPROVEMENT:
i, NEW STRUCTURE
O ROOM ADDITION(S)
O PORCH ADDITION(S)
O DECK ADDITION(S)
O REMODEL
_ Basement Finish only
O ACCESSORY BUILDING
O DETACHED GARAGE
O ATTACHED GARAGE
E DEMOLITION
Manufactured
Trusses: _Y _N
Sump Pump: i/Y ?qPJ,
-1. CAgED rv1?'
For Single Family and Two Family dwellings,
days of the date of issuance of the building r
structure permits are subject to the General A
I, the undersigned, agree that any construction., recon?rr?pp
requested bV this appliation will comply with, and mhfttrhr!"o, appBcabl
239) and amendments, adopted under authonty of LC-367 et sea, General A
kitchen, bath, and floor dram's are connected to the sanitary sewer. further
Occupancy leas been' d ssueby the De a of Community Services, C
Ownta or Aamorized Agent
S NT `
I CO Cr0 L T P T
's Indiana 1 tote Lice #, pUG 3 0 2007
ire
i4
Which plumbing codes will be apLRyd to the construction: '
? International Residential Code jjndianaXfil
k Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
E O POST & _ BEAM -PIER
BASEMENT(WALKOUT:Y?IVP/)
is valid only if construction commences within 180
:d) within IS months of the issuance date. Class I
4arding expiration time frames for beginning and
ton? .
non, o:?al.emtion of a sauctu[e, or any change is the use of land o; structures
qr) e of l'diana,and the-Zoning Ordinance of Carmel Indiana-1991 (Z:
l of the Sure of Indiana, and all Acts amendatory thereto. I further certify that only
that the construction will not be used or occupied until a Certlh'cate of
Indiana. /J
J'KU NGi' Ae
Date
OFFICE USE ONLY: *******"`:********s.?r****s******:*.******a*ss****** ss•r. x:*:*:s*****.**********
Filing Fees:
PECTIONS RE UIRED: Base Ins
ections: Charged Re-
Upper Footin Lower Doti Under Slab p
S ?U Reviews
Cert. of Occupancy:
Meter B Final Si
h 1n
P.R.I.F.:
O? G .UO
Additional Fees
L
T ?
T L
, ,
Reviewed/Approved: Dept. of Community Services (Date)
S:Nnrn]WFOrm;7_P RESIDENTIAL Fee Received by:
Date