HomeMy WebLinkAbout07110020 Application4YY Of f'aHy.F? Permit #: 071 1
City of Carmel/Clay Township
RESIDENTIAL IlMTROVEMENT LOCATION PERMIT APPLICATION
.!.uotrt0 .p,% For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NE: PHONE:.
C y '1 FAX:
OF ?Tr rn
RECORD: STREETADDRESS: C1T1': STATE:
/7 ZIP:
lpl, U -• ,
BUILDER'S EMAIL DDsS:
1 lt.G? fp C,,.t1' ?Q ^ ST METHOD OF GONTACT:
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Ct1. b
0.Sh, 2 n1. iG l
PROPERTY rvq?e: _
t f r ?nP??ne ' M h _ „ CTjC FAX:
OWNER.
STREET ADDRESS: v,, ht
ATE:
ZIP:
LOCATION LOT #: SUBDIVISION NAME: y v5 " T!A ZONIN _
CC
& PROJECT `'s ^r [
JJ
INFO: ADDRESS OF ONSTRUCTION: SQUARE ^
FOOTAGE:
J r
SEWER UTILITY
PROVIDER: C-?cczW? VIA R UTILITY
PROVIDER: ESTIMATED COST OF CONSTRUCTION: ?t
(EXCLUDING LAND VALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION i
AND/OR COUNTY WELL AND/OR SEPTIC PE
NUMBERS
TAC DATE
S BZA / BP%V DOCKET
RMIT #5 (IF APPLICABLE):
\- D (ni n I7n r?
I?r (f U f
S
;
( ); ')
o LS
FLOOD ZONE AREA DESIGNATION(S) Ib 1
1 TAX MAP PARCEL #:
10
NOV
Ifl
FOR THIS PROPERTY: 22007
TYPE OF CONSTRUCTION:
SINGLE FAMILY
O TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time--
O RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit: _Y N
Lot Split: Y N
TYPE OF IMPROVEMENT:
NEW STRUCTURE
O ROOM ADDMON(S)
? PORCH ADDITION(S)
O DECK ADDITION(S)
? REMODEL
_ Basement Finish only
D ACCESSORY BUILDING
C1 DETACHED GARAGE
? ATTACHED GARAGE
? DEMOLITION
Manufactured
Trusses: Y _N
Sump Pump: ZYN
PLUMBING CONTRACTOR By
\ 1) ' \1 Y-,P-Z - -?50
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
UQ International Residential Code w/Indiana Amendments
C Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
O CRAWLSPACE O POST & _ BEAM PIER
D SLAB eJCEBASEMENT(WALKOU7: YZN)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only it 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 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.
I, the undersigned, agree that any construction, reconsnvc-on, enlargement, relocation, or alteration, of a stricture, or any change in the use of land or strucrures
requested by tnis application will comply with, and conform to, all applicable laws of the State of Indiana, and :he "Zoning O:dinmce of Carmel Indiana -1993" (2-
289) and amendments, adopted under authority of I C. 36-? et seq, General Assembly of the State of Indiana, and all Acts a.•nendamry thereto I further certify that orly
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
ecupanc as been issued by t e Department of Community Services, Carmel, Indiana
`tee o s 2Ak
..r e. e•ne•...i. snt 1 C Print 17-1 { Date
OFFICE USE ONLY: xxxxx#xxxx*.xxxxxxxxxxxxxx:xxxxsxxa:sssza=sa=a=ra<a<a<={a=><a<+.+-------------------------
II?IS CTIONS RE ED: Filing Fees: a, ?,
/'- - ° Charged Re-
--Upper Footin Lower Footin Under Slab Base Inspections: at??. 5o Reviews
Cert. of Occupancy: JAS. 5?
h In A--Meter Bas Final Site ?I //??
I Ol I • OLD Additional Fees
P.R.I.F.: EN
TOTAL (P?1?
roved: Degj unity Services (Date) / f O
OtP RESIDE tL Fee Received bv' Date