HomeMy WebLinkAbout07110012 Application• 4?Y vi ^4P?
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City of Carmel/Clay Township
Permit #:0q f I r) I16?_
RESIDENTIAL EkT,1x OCATION PERMIT APPLICATION
For Single Family, Town ftrD"iaytg ce with af&&14QUditions, Remodels, & Accessory Structures
BUILDER ate ano or
NAME: EpT I CQII(eBE:
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FAX:
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RECORD: STREET DRESS: (C LAY TIOWNSH) STAi cc
1 ZIP:
O 0 INDIANA ? 7
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BUILDER'S EMAIL ADD ESS: J? BEST METHOD OF CONTACT:
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PROPERTY
OWNER: NAME' - // PHONE:
/`Zc" AL 'A-e_ 9W -60 6 2 -, FAX:
STREET ADDRESS: Clf/: STATE: ZIP:
LOCATION LOT C: u SUBDIVISION NAME: / `_ SECTION:
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`????°? C?t ZONING:
&PROJECT l
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INFO: ADDRESS OF CONSTRUCTION:
i lct k_ , -? SQUARE p
FOOTAGE: O,S
SEWER UTILITY
PROVIDER: G / tti WATER U71 ^ Q_7
PROVIDER: C? STIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) D J O
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOC U?Ygl?
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT p' APPLICABLE): / J
FLOOD ZONE AREA DESIG XO (4S t?\ v /
FOR THIS PROPERTY:' TAX MAP PARCEL >ti: L
?? 001
_. SING
? TOWN tT+1"
O TWO FA ?Qv
# Of un ', in i
this
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Additions, Renfi5dels. Etc.)
PROJECT INFORMATION:
Early Release
Permit: _Y_/N
Lot Split: _Y ?Iv
N3'- NfW STRUCTURE
O M ADDITION(S)
RCH ADDITION(S)
DECK ADDITION(S)
O REMODEL
_ Basement Finish only
ACCESSORY BUILDING
O DETACHED GARAGE
O ATTACHED GARAGE
O DEMOLITION
Manufactured
Trusses: YY N
Sump Pump: '-l'N
LUMBING CO NT OR: /
,o_ ?f I Pl? 4 w
Plumber's Indiana State License #:
G/0 Fl,G 0O P O P13
Which plumbing codes will be applied m the wnstrucbon:
O International Residential Code w/Indiana Amendments
niform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
O CRAWLS PACE POST & BEAM PIE
O SLAB ASEMENT (WALKOUT:_Y )
For Single Family and Two Family dwellings, additions, remodels, ancUor 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 I8 months of the issuance date. Class I
structure permits are subject w the General Administrative Rules of the State of Indiana (See 675 IAC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any construction., reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this application will comply with, and confG= to, all applicable laws of the State of Indiana, and the "Zoning Ordiaxnce of Carmel Indiana -1993" (Z•
259) and arrendmer Is, adopted under authority of I.C. 36-7 et seq, Generai Assembly of the State of Indiana, and all Acts amendatory thereto. 1 further eeruify that only
kitchen, bath, and floor drains ate cony ec,e m the sanitary sewer. I further certify that the construction will not be used or occupied until a CerriBcare of
Occu crhas been issued by the,nep .tent of community S ces, Carmel, Indiana.
Signature of Ormer w Authorized Agent Print Date
xxxx********x*****x*******xx******x*********xx*x**x*xx*xx*x*************xxx**x***
OFFICE USE ONLY:
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Fili
F
ees:
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INSPECTIONS QUIRED:
l Base Inspections: at17 5Z? # cx arged Re-
Y
pp r Footing Lower Footin Under Slab Reviews
50
5
Cert. of Occupancy: .
Cough In e er Base Inal Site
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LF
:
R T p
A W a Additional Fees
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Services