HomeMy WebLinkAbout07090129 Application?!umaxn.?
City of Carmel /Clay Township
Permit #: 01A
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME:
/v PHONE: FAX: ( 2_ z
j YG G d ` T
OF 1 1/
RECORD: STREET ADDRESS: CITY: STATE: ' . . ZIP:
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
i
PROPERTY NAME' PHONE: FAX:
OWNER
:
STREET ADDRESS: CITY: STATE: ZIP:
LOCATION L - S BDIVISION NAME: SECTION:
SA ZONING:
Z
PROJECT (Ry1I ..:p
&
INFO: ADDRESS,,,pppF MNSTRUCTION: i,iP®f >L4;7 0 Lq SQUARE
FOOTAGE: /SZ
SEWER UTILITY
PROVIDER:
G7_lf4? WATER UnLTFY
PROVIDER: ?6.-/_ v,-t c t
I
ESTIMATED C057 OF CONSTRUCTION: J J
EXCUDING LAND VALUE)
24 J O d.
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
'
S (IF APPLICABLE):
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #
FLOOD ZONE AREA DESIGNATION(S) r rya. O I? TAX MAP PARC
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
0---S-INGLE FAMILY
TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
C) RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit: _Y _N
Lot Split: _Y N
(PE OF IMPROVE NT: -1-71D
'°-AEW sTRU A?' Or?S
O ROOM ADDIT R 0,
C
a
O PORCH ADDTI IID
o
O DECK ADDITION(S) q9?
O REMODEL
_ Basement Finish only/4
O ACCESSORY BUILDING
O DETACHED GARAGE
O ATTACHED GARAGE
O DEMOLrrION
Manufactured
Trusses: -YN
Sump Pump: Y _N
Ca
0
,plied to the con [lion:
?I Code w/ Indiana mendments
w/Indiana Amendments
(Check all that apply for the new
construction areay
"WLSPACE POST & _ BEAM -PIER
GiLSCAB C3-8 SEMENT (WALKOLJr:_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 date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within IS months of the issuance date. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 IAC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any cons¢uction, reconstruction, 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 conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana -1993" (Z-
289) and amendments, adopted under authority of LC. 367 et seq. General -Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify, that only
kitchen., bath. and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certi&c to of
Occupanccyhhaass been issued by he Department of Community Senices, Carmel, Indiana_
Siang re of Owner or Age m nt Date
OFFICE USE ONLY: ***********************x***********************.::<:.:.:??=fit-.?+?.-_,
INSPECTIONS REQUIRED: Filing Fees: Z
Base Inspections: ?7 D
Upper Footin ower Footin Under Slab
Cert. of Occupancy:
ough Me er Final Si
P.R.I.F.:
WLX? i OTAL: ?.3--z(
\\\ Reviewed/Approved: Dept. of Community Services (Date) /
\S:PernvWForms/UP RESIDENTIRI. Fee ReceiV2d G1
Charged Re-
Reviews
Additional Fees