HomeMy WebLinkAbout07100128 ApplicationCity of Carmel/Clay Township Permit #Or716o l 22,
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME: ?S QIY c` C??<oM HpµEs PHONE: ?? B$5J FAX. Bis-75)0
OF
RECORD: STREET ADDRESS: CITY: STATE: / ZIP:
143leo cwf ra ¢eACe ?vo, s? zoo <A2xeL Inl 4Lo3Z
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
PROPERTY NAME: PHONE: FAX:
OWNER: DR - -46.-As SLAAA r`.p.
STREET ADDRESS: CRY: STATE: ZIP:
4(.o7_ C14AS6 oAe CT.
Z16ASO'txE 711 /
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LOCATION - LOT ` SUBDIVISION NAME: SECTION: ZONING:
S-?
59 CE Y_;CD 51?K 3
& PR03ECT ,
INFO: ADDRESS OF CONSTRUCTION: SQUARE
Z4
/
1111.9 .Si. mDQaa, Lr(. FO
OTAGE: ST
SEWER UTILITY WATER UTILITY ESTIMATED COST OF CONSTRUCTON:
PROVIDER: C u+Y PROVIDER: (J.fJ4oL (EX
? i - T;
'
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET Vill V J ?j
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND(OR SEPTIC PERMIT C'S (IF APPLICABLE):
0i
j Il
FLOOD ZONE AREA DESIGNATION(S) - I-i f I
kXMAPLWL1I
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FOR THIS PROPERTY:
-O° _cl?,
O
i
TYPE OF CONSTRUCTION:
O SINGLE FAMILY
? TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
RESIDENTIAL (For
Additions, Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_Y ?N
_Y ?N
TYPE OF IMPROVEMENT: PLUMBING CONTWA;FG V-:-= =-.
O
O
O
9
O
NEW STRUCTURE {{, LD pAEcHAnJ IwA?
ROOM ADDITION(S) 6
PORCH ADDrTION(S)l Plumbers Indiana State License #:
DECK ADDITION(S) ?1
REMODEL Y OI? n? C- 100 (sC+ __ Basement Finish onlyQG?l Which plumbing codes will be applied to the construction:
ACCESSORY BUILDING l O International Residential Code w/Indiana Amendments
DETACHED GARAGE I /
ATTACHED GARAGE Uniform Plumbing Code w/Indiana Amendments
DEMOLITION X
Manufactured
Trusses:
Sump Pump:
I Q' FOUNDATION TYPE: (Check all that apply for the new
construction area)
_Y N K CRAWLSPACE ? POST & _ BEAM -PIER
-,(-Y _N ?txc m.t6) Q SLAB ? BASEMENT (WALKOUT: Y_N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessorystructures, this permitis solid 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 18 months of the' e!pdpte. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 67000"Zoning F{nning and
completing construction. ^^t??
1, the undersigned, agree that any construction,, reconstruction, enlargement, relocation, or alteration a ,e o an or structures
requested by this application will comply with, and conform to, all applicable laws of the State of India, Ordirance of Carmel incluna -1993" (Z-
289) and amendments, adopted under authority of I C 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. 1 further certify that only
kitchen, barb, and Boer drains ate connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupancyhas been issued by the Department of Community Services, Carmel, Indiana
e j owJ ro f s
Signature of Owner or Authorized Agent Print [late
OFFICE USE ONLY: **********************s*************s**<************ /*! Y */D******..*rss******
INSPECTIONS REQUIRED: Filing Fees:
ere Footing Lower Footing Under Slab Base Inspections: ? ?? Y w Rte ewsRe-
Cert. of Occupancy:
(--Reush?rr? mar Site
P. R.LF.: Additional Fees
Gya;a /"(lSw tQ=??-O? T TAL:
Reviewed/Appr ved: Dept of Community Services (Elate) I
S:PenniVFonns/(LP RESIDENTIAL
Fee Received by:? Date