HomeMy WebLinkAbout07090033 Applicationasi m aR?,.
`J
City of Carmel/Clay Township Permit
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
wnias3j Far Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME PHONE: FAX:
? ^y?zy
F
O
RECORD: STREET AD SS:
azs kJr CTiYSTATE: ZIP:
VcK %. ? d
BUILDER's EMAIL ADDRESS! BEST METHOD OF CONTACT:
?F 1 °I f /
Gs c/ ?• _
PROPERTY NAME: PHONE: d
OWNER
:
STREET ADDRESS: CITY: A P:
LOCATION !OT A: /d/ SUBDIVISION NAME:
(' ? ? SECT O Y
?( v!
PROJECT
&
INFO: ADDRESS OF CONSTRUCTION:
3Y 7 iii FOOTAGE: 3 C ??
SEWER UTILITY
PROVIDER:
CTiA?e WATER UTIU?Y
PROVIDER: /'
4?;-x ftit ESTIMATED COST OF CONSTRUCTION: U O
(EXCLUDING LAND VALUE) 2C7 J t:t ?
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION ( BZA f BPW DOCKET ?/ /`?!'j/•?(? /yy?
(/ / fl C
fk.!J
,
OR SEPTIC PERMIT #'S (TF APPLICABLE): iF S
AND
NUMBERS; TAC DA /
TE(S); ANDJOR COUNTY WELL .
C
? f ??
/
FLOOD ZONE AREA DESIGNATION(S)
PERTY TAX MAP PARCEL 4:
FOR THIS PRO :
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
"'9
?' SINGLE FAMILY O-1 Iw STRUCTURE ?
A- 4k? f G? y f
:
? TOWN HOME p ROOM ADDITION(S)
S Plumber's Indiana State Li nse #: J
/?
`t
r
? TWO FAMILY
f
i
b
i )
(7 PORCH ADDITION(
DECK ADDITION(S) _
I® Q
.?
# o
un
ts
e
ng CI
constructed at this ? REMODEL Which PI mbing codes will be applied to the construction:
time:
? RESIDENTIAL (For _ Basement Finish only
? ACCESSORY BUILDING
ternational Residential Code w/Indiana Amendments
Additions. Remodels. Etc.) ? DETACHED GARAGE
O Uniform Plumbing Code wfIndiana Amendments
.? ATT ?,E
PROJECT INFORMATION: DE eC, to c :FOB CONJ MpAXMTYPE: (Check all that apply for the new
Jlla
Release
Early
N ' w vrilh F,7,Q
Manttfa arced O- f ^,SF? t
Y ate a
.??lati
pll3
o Lccal -^Od
PI
R
BEAM
l +'CRAW LSPRCE CD POST&
Y
T
Permit: ?Y
Lot Split: ?YN (
,.^,
r?
Sumprrmo{F?0rJU'`l „
E
-
-
2S.
i?Y-Jr't R§}gg ?--6SEMENT (WALKOUT: Y ?TJ)
For Single Family and Two Family dwellings, additions, remodels, an tructures?['?pZRs valid onlyif construction commences within 180
davs of the date of issuance of the huilding permit, and must be completed (Cer - ate of Oceupancy.issued) within is months of the issuance date. Class I
stt wre permits are subject to the General Administrative Rules of the State of Indiana (See 675 WC 12) regarding expiration time frames for bEginning MIA
mmple ting construction.
1, the undersigned, agree hat any ca'"Crion, reconstruction, en!atgecr_ent, -elorarion, or alteration of a strseture, a- sr_v change in the use of land or structures
requested by this application u ill comply with, and cohform to, all applicable Saws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana - 199Y (7-
289) and amendments, sdaptec under au tla toty of I C. 3&7,1 seq, General Assembly of the State of Indiana, and all Acts amendatory thereto- 1 Furth ec certify that only
:atehen, 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
Occupancyhas been issued bytt a De, aztr rat of Comutunity Services, Carmel, Indiana. p
Sign Wpwnelo prized g Print OaEe
OFFICE USE ONLY: ***taxxxxxxxxxx*xxxxxxxxxx.xa:**sxx*x*x*wwwxxxaaax*********n*x*x?txsss*asazsxxx*
INSPECTIONS REQUIRED: Filing Fees: -7 -7 `1!d
Base Inspections: a D it Charged Re-
Upper Foot's ., wet ootm - Under Slab. ?R Reviews
Cert. of Occupancy: s60
Rough Meter Final P. R.I. F.: ?Y rrpl ii. 00 - AddiFional Fees
I OL l
T T L:?Z `1T
Reviewed/Approved: Dept. of Community Services? (Date)
S;re„niulw.VILP RE'SIDEBnat ?) illll f ?e ecetied Date