HomeMy WebLinkAbout07110079 Application,;,,?. Permit #:-m !
City of Carmel/Clay Township
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF NAME PHONE: FAX:
i4 3rI?ZSrl,96?S sa?n?
RECORD: STREET ADDRESS: CITY: STATE: ZIP:
333 F- 6 17a -9l. _7d, 11S fLl ;L a d
BUILDER's EMAIL ADDRESS: yE M OD OF CONTAQ:
JTBA?RAv£TT m EzG64. C» ?c£Lc?3f?-95?
FAX:e4a" 41
NAME: 7G•,?w PHONE:£ Ti7 f°Z--9.Z_j1
PROPERTY
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:
STREET ADDRESS: CITY: STATE. ZIP.
/Z361 [, Zr vo, ?E LAS-1/ Sn/ `>14 Z
LOCATION LOT #: SUBDIVISION NAME: SECTION: ZONING:
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& PROJECT o
INFO: ADDRESS OF CONSTRUCTION: SAGE: r
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SEWER UTILITY WATER UTILITY ESTIMATED COST OF CONSTRUCTION:
PROVIDER: PROVIDER: (EXCLUDING LAND VALUE) SQO oG?,
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET .
e ?o.?1TiCtcL7t e?
: 73Ak=--
IF APPLICABLE
)
,
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #s (
ROOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL
/A
FOR THIS PROPERTY: r!
TYPE OF CONSTRUC11`1011:
.k SINGLE FAMILY
O TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
0 RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
NEW STRUCTURE
O ROOM ADDITION(S)
O PORCH ADDITION(S)
? DECKADDITION(S)
? REMODEL
Basement Finish only
PLUMBING CONTRACT (yi f?
G / If ? c 11 L5
: 2401
Plumber's Indiana State c sse #
/40v 19
PROJECT INFORMATION:
Early Release
Permit: _ _Y /
Lot Split: __Y >C N
Which plumbing codes will
to the construction:
O ACCESSORY BUILDING O International Residen n ments
? DETACHED GARAGE
O ATTACHED GARAGE §6 Uniform Plumbing Code w/Indiana Amendments
O DEMOLITION \o% FOUNDATION TYPE: (Check all that apply for the new
Manufactured /' \at construction area) UC-C,ON
Trusses:/ Y N L•1PAC t? & -BEAM -PIER
al I.
Sump Pump: / Y _N?EL?.SEO CtagrtWgN^LW?LKOUT:?YN )
For Single Family and Two Family dwellings, additions, remodels, and/or ace`esorvtruic>YS'commences within 180
days of the dace of issuance of the building permit, and must be completed (Cemfi u '1fflt°wdddS;--A?,••`_Ln s off the issuance date. Class I
structure permits are subject to the General Administrative Rules of the State ' ng expiration time frames for beginning and
letin
comp
t o:Aany change in the use of land or structures
I, the undersigned, agree that any construction, reconstruction, enlargement, re] or a tendon of a 1t' vp N
requested by this application will comply with, and conform, to, all applicable laws of the State of Indiana, and the'Zoning ordinance of Carmel Indiana - 1993' (2-
269) and amendments, adopted under authority of I C. 36-7 et seq. General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the sar.Lary sewer. I further certify, that the construction will not be used or occupied until a Certificate of
O Cy be^ ed by the De tment of Community Services, Carmel, Indiana. .?[
46
5 tore of Owner or Authorized Agent Print Date
OFFICE USE ONLY: **xxx**xxxxx*xxxxx*xxxxxxx****xx*xxxxxxxxx***xxxxxx*• rxxLxxx**xxxxx*****x*xx
Filing Fees:
INSPECTIO UI ??7 # Charged Re-
Base Inspections: cC G Revews
per Footing wer Footi Under S
Cert. of Occupancy: )
ough In Meter Base inal Site Additional Fees
T L• b ?? `
Reviewed/Approv Dept. of Community 5'SCAN ?e) tt ' r
S:?ermitslramsdt.P RESIDErrn k ? \`II L- Received ho: Date