HomeMy WebLinkAbout07120030 ApplicationCity of Carmel/Clay Township Permit #: n 7
RESIDENTIAL BUROVEMENT LOCATION PERMIT APPLICATION
x,i?cope ` For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF NAME: L_ ?, f + PHONE./ I I `C IONA-L
1,
RECORD: STREET ADDRESS: CITY: STATE: ZIP:
BUILD
ER's EMAIL ADDRESS: BEST METHOD OF CONT
11
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L 1 . (-0 n-r J ?. Lti Ls
PROPERTY
OWNER: NAME:
(rd'r. r,' PHONE:
(3t1 ?33-Oat4 UtL L --7--2007
57REETADDRESS:
3l o' ?4 'jtAZC'r CITY: TE: ZIP:
c: v?? Z y
LOCATION
& PROJECT LOT #: 35- SUBDIVISION NAME: UJ C55t' r t? Rid ] - SECTION: ZONING:
S' M:., ;;d L 21 eta
INFO: ADDRESS OF CONSTRUCTION: ? a7 ps'
•?A SQU
STAGE:
SEWER UTILITY ?L
PROVIDER: 1 ' WATER UTILITY
PROVIDER: ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) IY-r 4,2-3. O0
{ 1
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): .-
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
SINGLE FAMILY
? TOWN HOME
? TWO FAMILY
# of units being
constructed at this
time:
Qi( RESIDENTIAL (For
Additions, Remodels. Etc)
PROTECT INFORMATION:
Early Release
Permit: _Y -N
Lot Split: _Y __.A
PLUMBING CONTRACTOR:
1.' 1A
Plumber's Indiana State License #:
Which plumbing codes will be applied to the cansVuction:
O International Residential Code w/Indiana Amendments
O Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
D CRAWLSPACE ? POST &_ BEAM -PIER
(E.7 SLAB ? BASEMENT (WALROUT:_Y_N )
TYPE OF IMPROVEMENT:
G NEW STRUCTURE
? ROOM ADDITION(S)
? PORCH ADDITION(S)
ODECK ADDITION(S)
J p REMODEL
_ Basement Finish only
? ACCESSORY BUILDING
O DETACHED GARAGE
? ATTACHED GARAGE
? DEMOLITION
Manufactured
Trusses: _Y N
Sump Pump: _Y
For Single Family and Two Family dwellings, additions, remodels, and/or accessorystructures, this permit is valid only if construction commences within 180
days of the date of issuance of the building permit, and most 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 E75 LAC 12) regarding expiration time frames for beginning and
completing construction.
1, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alv ration of a structure, or any change in the use of lane or structures
requested by this application will comply with, and conform to, all applicable laws of the S? to of Indiana, and the `Zoning Ordirance of Carmel Indiana -1993" (Z-
239) and amendments. adopted under authority of I.C. 767 or seq, General Assembly of the State of Indiana, and all Acts annendacary thereto. I further certify that only
kitchen, bath, and D Brains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a CertlSratc of
Occapancyhas4 issued by the Department of Community Services, Carmel, Indiana.
Signature of o(vnet or Authorned Agent Print J date
FICEfJSE ONLY:****************.:****************.****************************************** ***
INSPECTIONS REQUIRED: Filing Fees:
Base Inspections: # charged Re-
Upper Footing Lower Footing Under Slab ?? 5n Reviews
Cert. of Occupancy:
Rough Meter Base f Sit
Z- ,p
1 Revie prov I. of Community Services (Date)
S:PermiglFams/llP R DEIlTTAL
Y ra
P.R.I.F.: Additional Fees