HomeMy WebLinkAbout07090080 ApplicationCity of Carmel/Clay Township Permit: 7d 02
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
•rNagn?.?• For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME. PHONE: FAX:
OF /•? 'o GU _ Z - Zy •y -/Z o
RECORD: STREET ADDRESS: CITY: STATE: ZIP:
BUILDER'S EMAIL ADDRESS: BE METHOD O CONTACT:
L U cwt s S/?Gi1 o.r--
PROPERTY NAME. PHONE: FAX:
OWNER: • >I Lo r //// Z'1 / HVZO
STREET ADDRESS: CITY: STATE: ZIP:
LOCATION LOT #: SUBDIVISION NAME: SECTION: ZONING:
& PROJECT Z Z /Ua? 2i, Z
INFO: ADDRESS OF CONSTRUCTION:
Y// O SQUARE
FO OTAGE:
SEWER LMLTTY R
[I ESTIMATED COST OF CONSTRUCTION
PROVIDER: PR VIDER: (EXCLUDING LAND VALUEW - 6GG
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); ANDXR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
CO
NDITIONAL-
FLOOD ZONE AREA DESIGNATIONCS) TAX MAP PARCEL #:
FOR THIS PROPERTY: ff- 01 - &6- -O L - 03- O 3L 6 00
TYPE OF CONSTRUCTION:
LD SINGLE FAMILY
C TOWN HOME
? TWO FAMILY
# of units being
constructed at this
time:
0 RESIDENTIAL (For
Additions. Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit: _Y _N
Lot Split: _y -N
TYPE OF IMPROVEMENT:
? NEW STRUCTURE
? ROOM ADDITION(S)
O PORCH ADDITION(S)
O DECK ADDITION(S)
O REMODEL
Basement Finish only
_
O CESSORY BUILDING
AC
TW DETACHED GARAGE
O ATTACHED GARAGE
O DEMOLITION
Manufactured
Trusses: -kYN
Sump Pump: Y _,X N
PLUMBING CONTRACTOR:
IAA
Plumbe'r's Indiana State License #:
Which plumbing [odes will be applied to the construction:
D International Residential Code w/Indiana Amendments
D Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
0 CRAW/LSPACE O POST & BEAM -PIER
Ii1?5t1(8 ? BASEMENT (WALKOUT:_Y_N )
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 daze of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Clus 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 construction, rewnttruc n-enlargement, relocation.. or alteration of a structure, or any change in the use of land or structures
requested by this application will comply with, and? Pco rm to, all ap 'cable laws of the State of Indiana, and the'Zoning Ordinance of Carnd Indiana -1993' (Z-
289) and amendments, adopted under authority of / 36-7 et seq, Gene Assembly of the State of Indiana, and all Acts amendatory thereto. I further ce dfy that only
kicchen, bath, and floor drains are connected to t: sanitary sewer. I furt r certify chat the construction will not be used or occupied until a Cert&care of
Occuparrcyhas been issued by the Departme>?f Comntun!Yy Services Carmel, Indiat/a1
n
IM 11//,) / G v cos i U
signature of Owner or Authorized Agent
OFFICE USE ONLY: ******************'* **
pFoofing ONS REQUIRED:
wer Footing Under Slab
7tRevie rBas Final Site
S:Pe.1WFooTWTLP RESiDEuo7
Community Services (D ate)
Filing Fees:
Base Inspections: 7oS. ?? Charged Re
Reviews
Cert. of Occupancy: S S• SO
P R. T. F., Additional Fees