HomeMy WebLinkAbout07100121 Application`?V ov Cggy?
City of Carmel/Clay Township
Permit #:U I1OD12-1
RESIDENTIAL HVIPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
I l ? PHONE: R??
K?[ 1, ? e q ( FAX:Sr) I `9 `r-3
E' L /n i?l . of .ft a7
OF
O
RECORD: STREET ADDRESS: ?0 CITY:
/17 22 L9Pc( aAe PLIP(et STATE: ZIP:
-TJG 6 033
BUILDERS EMAIL ADDRESS:
0 kj1 QFAL-1 @ AOL BEST METHOD OF CONTACT:
.C-0,71 lFW-58s/
PROPERTY NAME. PHONE: FAX:
OWNER:
STREET ADDRESS: CITY: STATE: ZIP:
LOCATION
& PROJECT LOT n: SUBDIVISION NAME:
wo Oat,
2 N SECTION: ZONING:
S-1 2occ a
INFO: nL
ADDRESS 1? SULZIO?G(!?f7 [' 1I (J SQUARE
FOOTAGE:
SEWER UTILITY WATER UTILITY a 12b ESTIMATED COST OF C U
PROVIDER: PROVIDER: (EXCLUDING LAND VALUE) Cf (7 J i9
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET 76S .Z.10 - Atvh
NUMBERS; TAC DATE(S); ANDiOR COUNTY WELL AND/OR SEPTIC PERMIT a5 (IF APPLICABLE): 1"` (G ILO FSCPI'Y?jZ N -f AA it SS evq
ROOD ZONE AREA DESIGNATION(S) ?/??_ (Z ?;"'
FOR THIS PROPERTY: TAX MAP PARCEL ?r:
f7?
TYPE OF CONSTRUCTION:
9 SINGLE FAMILY
0 TOWN HOME
0 TWO FAMILY
# of units being
constructed at this
time:
7- RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit: _Y VINi
Lot Split: _Y N
19 FPPE-Fir
NEW CTURE
llc? ROO DITION(S)
O POR rcI
-
O DECK ADDITION (ST
0 REMODEL
_ Basement Finish only
O ACCESSORY BUILDING
0 DETACHED GARAGE
O ATTACHED GARAGE
O DEMOLITION ?-?
Manufactured . N. 1
Trusses: f1Vj
Sump Pump: if?y N
For Single Family and Twv Family dwelling
days of the date of issuance of the building
structure permits are subject to the General
I, the undersigned, agree that any construction, reconstructE)t;b1atg&fntnt
requested by this appiiration will comply with, and confotyL?q r? 9Dl?ic-4yr
289) and amendments, adopted under authority o` I C. 36-Tatlskgt G`A'reral .4!
idtnhen, bath, and floor drains are connected to the sanitary sewer. I lumber'
Occu cy?hm been issuedbythe D5;a me[ t Community se
signature of/66rner or Auihwieed Agent 11 / Pant
OFFICE USE ONLY: *********************** *?
Lower
?j
r,
PLUMBING CONTRACTOR:
Plumber's Indiana State License #: 7r,_
Which plumbing codes will be applied to the construction:
O International Residential Code w/Indiana Amendments
O Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Ilam CCRAWLSPACE O POST & _ BEAM
ILV.a 5 BASEMENT (WALKOUT:Y
is valid only if construction commences within 130
clit.vithin IS months of the issuance dace. Class I
'Ang expiration time frames for beginning and
?_...: .
n a . structure, or any change in [he use of land o: structures
tfd e e Indiana, and the'Zoning Ordinance of Carmel Indiana - Mr(Z-
semb _ f Indiana, and all Acts amendatory thereto. 1 further certify :hat only
iify_that the construction will not be used or occupied until a Ca ctiiicare of
umel, Indiana.
'?1k+oNG? Qr?eFf L/? l° /7?° 7
/ Date
filing Fees:
Base I ections: # Charged Re-
Reviews
of Occupancy:
Rough In efer Base Final Site
P.R.I.F.:
Reviewed/Ap oved: Dept. of Community Services (Date)
S:nenv*s1Forms/ILP R'_SIDi:NrT -1L
Fee Received by:
Additional Fees
[
Date