HomeMy WebLinkAbout07100219 Applicationo`" "? .. Permit #:o'7 I oU Q-? 9
City of Carmel/Clay Township
RESIDENTIAL EAPROVEMENT LOCATION PERMIT APPLICATION
?txmcaP+% For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAt4E:- PHONE: FAX:
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RECORD: CITY: STATE:
STREET ADDRESS:
(?5 ? . C*VeL- WOE, ( 210A l ZIP.
BUILDER'S EMAIL ADDRESS: ,-?.S ` BEST METHOD OF CONTACT:
(.rQt;i N C:, j) l P-1t kw S. _C;
PROPERTY NAME: PILIONE: FAX:
PAD SI4lI-rg ° lci(4
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OWNER: '
STREET ADDRESS: CII'!: STATE:
Z3 S&CffP _ _ DbO OT" CAlw a- • ZIP'
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LOCATION LOT x SUBDIVISION NAME: SEMON'
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ZONING:
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& PROJECT I
INFO: ADDRESS OF CONSTRUCTION: -
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QUAR `r(Gj
SEWER UTILITY
PROVIDER: I WATER UTILITY
/,yyJ a, PROVIDER; ESTIMATED COTT OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZAI BPW DOCKET D I'0 IJ _' ??, 1
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NUMBERS; TAC DAT E(S); AND/OR COUNTY WELL ANWOR SEPTIC PERMIT #'5 (IF APPLICABLE): ?
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FLOOD ZONE AREA DESIGNATION is) TAX MAP PARCEL 4: pp
OCT ?!?
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FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
D SINGLE FAMILY
D TOWN HOME
D TWO FAMILY
of units being
fp" constructed at this
V time:
RESIDENTIAL (For
Additions. Remodels. Etc.)
PROIECTINFORMATIO
Early Release
Permit: _Y _N
Lot Split: Y _N
TYPE OF IMPROVEMENT: PLUMBING CONTRACT OV-.
rn NEW suCT'URE
ROOMh1 ?a661fibNSD FOR C??t I nor I N to License ter
D PORC46
? D nDM _ _ ; Pliancy Wit?alf-rat e _
codes will be applied to the construction:
D ACqg;Fq ? "t "DING terra d( idential Code w/Indiana Amendments
DETACHEDTaARAGE "OO'Un(fnlin7P011'"I"
D ATTACHED GARAGE , Code w /Indiana Amendments
G DEMOLITION
FOUNDATION TYPE: (Check all that apply for the new
Manufactured construction area)
Trusses: _y _N O CRAWLSPACE POST& BEAMPIER/
Sump Pump:
_Y N 0 SLAB BASEMENT (WALKOUT:_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
davs o£ the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class l
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.
I, the undersigned, agree that any mnstmction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the .sse of land or structures
requested by this application wiil comply with, and conform to, all applicable laws of the State of Indiana, and the 'Zoning Ordinance of Carmel Indiana-1993" (7-
289) and amendments, adopted under authority of I C.36-7 et seq, General Assembly of the State of Indiana, and a11Ac;s amendatory thereto. 1 further certify that only
kitchen, bath nd"Eoor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupancy as been issued by the Department of Community Senrices, Carmel, Indiana.
-'tom IDI?:,Dlzl -7
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signatu of Owner or Authorized Agent Pont Date
OFFICE USE ONLY: ****************s********ss******«****sx**s****:************ ***s **s*****s******
Filing Fees:
INSPECTIONS REQUIRED: 1 llj
Base Inspections: d0 # Charged Re-
Upper Footing Lower Footing er Slab ?G Reviews
D Cert. of Occupancy:
Rough In Meter B se final Site
P.R.LF.: Additonal Fees
T d? J 0 a 0
Reviewed/Appro : Dept. of Community Services (Date)
S:Penn1WFcr11s1ILP RESIDEN L Fae geralvM ?,: ?' Date