HomeMy WebLinkAbout07120016 Applicationtj o? CigM\
City of Carmel/Clay Township Orl ? a 00 (Perrnit .
i RESIDENTIAL HVIPROVEMENT LOCATION PERMIT APPLICATION
. /agfnxa. For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME:
C4I &I PHONE
f E-S -721 FAX:
OF
RECORD: STREET ADDRESS
9-(05 : CITY: STATE
_ AeM Z-- 0 L)"- ZIP:
ci&Q3- -
BUILDERS EMAIL ADDRESS: BEST METHOD OF CONTACT:
?I?FIlIIG?r? F?C"Y!'ICS. LL;?ti(
PROPERTY NAME: PHONE: FAX:
OWNER:
STREET ADDRESS
411 -2 : CITY: STATE:)
5C (? 6 4-/i ? ! t 71 P:
`( (mac;
LOCATION LOT I': SU W ON NAME: C SECTION I
3 NING: S
2? +
kx0 rr
& PROJECT
INFO: ADDRESS OF CONSTRUCilO
/ LI "] St•?•t'??,
l
1 SQUARE
FOOTAGE:
UTISEWER
/
PROVIDER:
PRA LF
???{/I/f
DER: ryr OST OF
(EXCLUDINGCLAND VALUE ?N
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND{OR SEPTIC PERMIT #'S (IF APPLICABLE): a 4 t"Ir?,
F
J
V' REA DESiGNA?Ia
F FOR OD ZONE AREA ZONE A PROPERTY: A DE
?(
p TAX MAP PARCEL #: ?
NO ?
,
11
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TYPE OF eONST U ON: ( TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR: vy rpw of
?I
SINGLE FAMILY O NEW STRUCTURE e
' O TOWN HOME O ROOM ADDITION(S) Plumber's Indiana State Licens
: ,
O TWO FAMILY
# of units being O PORCH 9pDITIO( (S)
n WK-ADO ON S
?
constructed at this
time:
REMODEL >?1`(\
Basement Finish only
lamb nY y c? will be applied to the construction:
'
O RESIDENTIAL (For _
O ACCESSORY BUILDING O International Residential Code w/Indiana Amendments
Additions. Remodels. Etc.) O DETACHED GARAGE
O Uniform Plumbing Code w/Indiana Amendments
O ATTACHED GARAGE
PROJECT INFORMATION: O DEMOLITION FOUNDATION TYPE: igi apply for the new
Early Release Manufactured construction areal NCJ t69?-'
Permit: Y_N /Trusses: _Y Or. e4 ,G' SPOS-1ZirC BEAM _PIER
Lot Split: _Y Sump Pump: Y N ?r G PcjE tOOIASE AA i0i _Y_ _ N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessor+ °Oeuret•,4Bis`pe> t ts+?d?on1T `?y cc? trucrion commences within 180
days of the date of issuance of the building permit, and must be completed (Certificate of catpanLyksuedJ wktl+iii 78 months of the issuance daze. Class I
structure permits are subject to the General Administrative Rules of the State of in 6fi'fdCt egar?ittlg,'aypiration time frames for beginning and
completing cons(??
I, the undersigned, agree that any construction, reconstruction, enlargement, Zan. pft a tT.fS of a smctu`re, or any change in the use of land or structures
mounted by this application will complywith, and conform to, all applicable laws o: the 1-te of Indiana, and the "Zoning Ordinance of Carmel Indiana -1993' (7-
289) and amendments, adopet0under authority of LC. 367 et ", Genezl Assembly of the State of Indiana, and all.Acts arnendaror; therero. 1 further certify that only,
kitchen, bath, and floor d ';ns & cmaected to the sanitarl sewer. I further certify that the construction will not be used or occupied until a Cerrbi to of
Occupancy l lots been isdu d'bv [h Deparment of Communiry Services, Carmel, Indiana. y{ J . C 11.x,
Signature u(evr'er or Autthorized Agent Print Date
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OFFICE USE ONLY:
INSPECTIONS REQUIRED: Filing Fees:
Base Inspections: # Charged Re-
Upper Footing Lower Footing Under Slab Reviews
Cert. of Occupancy:
ough In Meter Base Lna Site
C -y6-'q +2-g-0Z
Reviewed/A roved: Dept, of Community Services (Date)
S:Peanns/Forms/ILP RES:DEN
P.R.I.F.:
Additional Fees
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