HomeMy WebLinkAbout07100170 ApplicationPermit #:hru ob l 'iD
r : ^ City of Carmel/Clay Township
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
`.txtipx?%' For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME. PHONE. FAX.
3 317-730 31 30-7318
OF
RECORD: STREET ADDRESS' CITY: STATE: ZIP:
y 7
5 E balklic S -E aoo TA)b i P; s 1
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
I ALMD D Fs' i4E5
PROPERTY NAME: PHONE,
S FAX:
OWNER: N 317
Q S ? E S 347-7300 313q! - 7319
STREET ADDRESS: 7& STATE: ZIP:
r
7 r?
a
LOCATION LOT #: SUBDIVISI SECTION: ZONING:
5 -)
& PROJECT )12 KESi
INFO: ADDRESS OF CON 7UCTION:
N J/ 0/ ? SQUARE r•1
R
Oa3 i
?C _
/
SEWER UTILITY WATER UTILITY
01186 Osi OF CONST$qyCIION: _
MA
DING LAND VALUE)
6
-
Y
PROVIDER: C T Sill R , 1 f/ 7
NOW
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
UMBERS; TAC DATE(S); ANDIOR COUNTY WELL AND(OR SEPTIC PERMIT #'S (IF APPLICABLE): 5 co
W
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL #• D
FOR THIS PROPERTY:
,OF CONSTRUCTION:
T SINGLE FAMILY
LD TOWN HOME
? TWO FAMILY
# of units being
constructed at this
time:
? RESIDENTIAL (For
Additions, Remodels, Etc.)
PROTECT INFORMATION:
Early Release f
Permit: _Y ??r
Lot Split: Y _N
TYPE OF IMPROVEMENT:
NEW STRUCTURE
•? ROOM ADDITION(S)
? PORCH ADDMON(S)
G DECK ADDITION(S)
? REMODEL
_ Basement Finish only
? ACCESSORY BUILD-
--0 DETACHED GARAGE
O ATTACHED GARAGE
O DEMOLITION
Manufactured
Trusses: /I _N
Sump Pump: ! Y _N
PLUMBING CONTRA O L?LJ OCT 2 5 2007 I I
PAU1 F Sming u {
Plumber's Indiana State Li e #:
WhiCp plumbing codes will be applied to the construction:
l- international Residential Code wJIndiana Amendments
? Uniform Plumbing Code wJIndiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
O CRAWLSPACE O POST & _ BEAM HER
D SLAB "ASEMENT(WALKOUT:_Y ?N )
For Single Family and Two Family dwellings, additions, remodels, andlor accessory structures, this permit is valid only if conswction 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 issuance date. Class 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 :hat any construction, reconstruction, enlargement, relocation., or iteration of a structure, or any change in the use of land or structures
requested by this application will comply w;th, and conform co, all applicable laws of the Sate of Indiana, and the -Zoning Ordinance of Camel Indiana -1993' (2-
289) and amendments, adopted under au:horiry of I.C. 36-7 er seq, General Assembly of the Scare of Indiana, and all Acts amendatory therein. I further cendy that only
kitchen, bath, and Floor drains arc connected to the samtar; sewer. 1 further certify that the construction will not be used or occupied until a Cerci&ate Of
Oppccupancyhas been issued by the Department of Community Services, Carmel, Indiana.
deYtt,8 RTJkix? -Arm - ko2, A QittnSOwY-{?E????NE 10413J07
Signature of Oa or AuthgAaecl Ag Print Date
OFFICE USE ONLY:........
Filing Fees:
Base Inspections:
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