HomeMy WebLinkAbout07100123 Application?`' City of Carmel/Clay Township Permit #:Orl l OOL23
<<?, RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER Of "A"tE
us K ?JI { l E PHONE
S FAX
3413-?Ill 9 3 -?5 9
RECORD:
STREET ADDRESS CITY STATE ZIP
aE bZ -F 2
o
BUILDER'S EMAIL ADDRESS BEST METHOD aMAQy (? M
PROPERTY NAME PHONE OC 1FA
X M1
2007
OWNER:
STREET ADDRESS CITY SPATE ZIP
BY
LOCATION LOT Y SUBDIVISION NAME
_ SECTION ZONING:
&PROJECT
LJ/N SD2
1116
peovs ?7_
INFO: ADDRESS OF CONSTRUCTION SQUARE a??D
FOOTAGE: T
05O (
I
-
SEWER UTILITY WATER UiI
L
T' ESTIMATED COST OF CONSTRUCTION:
PROVIDER: PROVIDER: ^?? / (EXCLUDING LAND VALUE) SQQ t?
O
NAME OF UTILITY EXCA
NUMBERS; TAC DATE(S); :ON CONTRACTOR; PLAN COMMISSION ! BZA ( BPW DOCKET
IOR SEPTIC P IT #'S (IF APPLICABLE):
TOR COUNTY WELL AND
AND
ZL..
or) I DO I
,
,
TYPE OF CONSTRUCTION:
t?A SINGLE FAMILY
b TOWN HOME
O TWO FAMILY
# of units:
O MULTI-FAMILY
# of Units:
O RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit: Y _X_N
Lot Split: Y _?(_N
O POfi:La ADBIT?3, ''
O REMOaEl- O n` Q•'> ' ,o
O ACCESSb?RjIpwtp__ik!
O DETACHED G?(R2A(`iE
O ATTACHE?RAI?iE ?l?T
O DEMOLITION q? ::r•J
Manufactured
Trusses: Y ?N
Sump Pump: _)?_Y N
PLUMBING CONTRACTOR:
403 yE.e *epzL
Plumber's Indiana State License
i0
O
codes will be applied to the wnstruction:
nal Residential Code w/Indiana Amendments
tubing Code w/Indiana Amendments
Construction Code)
Does any part of the property lie within a special Flood designation area: _Y _)?_N
(Check all that apply for the new
O POST & BEAM
BASEMENT
WALKOUT:_X_Y N
For Single Family and Two Family dwellings, additions, remodels, andlor 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.
1, the undersigned, agree that any construction, reconstruction, enlargement, relocation- or alteranan of a structure, or any change in the use of land or
srructUms requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the `Zoning Ordinance of Carmd
Indiana - 1993' (Z-2264) and amendments, adopted under aucheriry of [.C. 35.7 et seq, General Asstnbl,; of the Stare of Indiana, and all Acts amendatory
thereto. I further certify :hat only ldrehen. harh, and floor drain, zre tun cted to the sanitap'sewer. I further certify that the construction will not be
used oi' occupied until a Cert4"re ofOccup mccr has been is5ned by e Department of Community Services, Carmel, Indiana.
or
OFFICE USE ONLY: **********
INSPECTIONS RE
Rough In
Final
Reviewed/Approved: Dept, of Community Services (Date)
S:PeM1t5!F.1/TLP RESIDENTLIL
. ? /
Filing Fees:
Base Inspections: # Charged Re-
,l 0
Cert. of Occupancy: Reviews
SS s
P.R.I.F.: 0 Additional Fees
roa• 2 . ? 0
Fee Received b,: