HomeMy WebLinkAbout07120015 Application^w EityofCarmel/Clay Township Permit #:0
x ' r" RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
alp?F j For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME: - PHONE:
CGS1R19cre 10o _ 6slI) FAX:
OF
RE STREET ADDRESS: CITY: STATE:
CJ i EARhIc? I?. Ste Z0= Qine?
3m ZIP'
IAI
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BWLDERS SS. I, OAST, OF CONTACT:
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'OROPEft'Y *NEIVOV
NAME: FAX:
OWNER: ?5??Ifle 4
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im. ATE:
STREET ADDRESS:
ZIP:
LOCATION l
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LOT #:
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O ZONING:
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&PROJECT lnrl
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INFO: 7?
AODRESSOF CTISTRUCF[O S°air' p (}nd LOCat v ? RVICE . .?
' SQUARE i f
FOOTAcE: '7$3
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'C . L
PPP 1
SEWER UTILITY •-•- ,' s" ?" t -
M1 ESTIMATED COST OF CONSTRUC TION:
PROVIDER: fI
A ER:(,?POL `kIN 1L}Rm ,C f
? 1 P (EXCLUDING LAND VALUE)
NAME OF UTILITY EXCAVATON CO RACTOR; P SSION / 670. i BPW DOCKET
NUMBERS, 'TA!, DATE(S); AND/OR COUNTY WELL AND(OR SEPTIC PERMIT #'S IF APPl1CABLE): UI TA r
ROOD ZONE AREA DESMNATION(S) t
` TAX MAP PARCEL #: V?ff
fO
FOR THIS PROPER TY: P
TYPE OF CONSTRUCTION;
SINGLE FAMILY
0 TOWN HOME
O TWO FAMILY
At of units teeing
constructed at this
time:
O RESIDENTIAL(For
Additions, Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit: _Y _N
Lot Split: Y L/N
TYPE OF IMPROVEMENT:
`K NEW STRUCTURE
0 ROOM. ADDITION(S)
O PORCH ADDITION(S)
O DECK ADDITION(S)
? REMODEL
_ Basement Finish only
n ACCESSORY BUILDING
0 DETACHED GARAGE
0 ATrACHED GARAGE
DEMOLITION
Manufactured
Trusses: -kY -N
Sump Pump: 1CY _N
PLUMBING CONTRACTOR: '01 of Afps
Plumber's Indiana State License #: J?6
e-'Mlcnc?zo?N
which Plumbing codes will be applied to the construction:
International Residential Code w/Indiana Amendments
? Uniform Plumbing Codew/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
? CRAWLSPACE ? POST &-BEAM -nER
? SLAB '!A BASEMENT (WALKOUT:`Y)_N )
Far Single Family and Two Fatnily dwellings, additions, remodels, andior accessary structures, this permit is valid only if eons ruction commences within ISO
days of the date of issuance of the building nerntit, and most be completed (Certificate of Occupancy issued) within IR 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
.Plating construction.
1, the undersigned, agree chat any constructicn, recc nsrrudion, enlargement, relocation, or alteration of astrucmre, or anv change m the use of lane or structures
requested by this applkarion will comply ?rh, and conform to, alI applicable laws ai the State of Indiana, and the "Zoning Ordinance of Carmel Indiana -1993' (Z;
239) and amendments, adoptedu derauthorhq) of LC. 36-7 et seq,Genenl AssemYv of the State o=Tndiana, and all Acts amendatory thereto. I Further certify that only
&itchm, bath, and or GIm connected to the sanitary sewer- Ifurther certify that the construction will not be used or orcupied until a CertiScate of
pccupancvhas i u the Department of Cotnmumty Services, Carmel, Ind )j
/SU6?r! /???lt{,? l/ 30 07
«__?.......?. ,.. .a«,,,:.w s..n.•r Print Date.
OFFICE USE ONLY: *****a'*"'*******•••*****sssssxxxss.=:?r==a<sa•..==+•-- -____ -- - - .. - - -
PECTIONS REQUIRED: Filing Fees: Charged Re-
Base Inspections: Reviews
o
Upper Faatir Lower FooV ng Lender Slab
Cert. of Occupancy:
`Meter B Fals,
Addi
tional Fees
l f t ?V
P.R.LF.:
Review f ppre ed: Dept. of Comriwaity Services (Date)
S.PermRy Po5a5IiLP RESIDERrrBL Fee Received bw e