HomeMy WebLinkAbout07120032 ApplicationCity of Carmel/Clay Township Permit CIO
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
rxelanP/ For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
'BUILDER "" lC,5 S75N Fat:
J350 X )b
RECORD: STREET ADDRESS: aFY:
l15q () rJ r 1E)Qj61AAJ \S sraTE:
(? ?mmE? i? ZIP:
X0032
BUILDER'S EMAIL ADDRESS:
IWME- Sfi0F-lAC-Q At L-1E.L' m BEST METHOD OF CONTACT:
E/?1A i v
PROPERTY NAME' PHONE: FAX:
OWNER
:
STREET ADDRESS: CITY: STATE: ZIP:
LOCATION
& PROJECT LOT SUBDIVISION NAME: SECTID :
q? 1 C EREr- ES77aT .-S ZONI
1-
INFO: ??FUI{lco uLYVIC?i 1?2 FOO?E: 5C>?5
SEWER UTILITY WATER UTIL17"Y_ )J ?/
PROVIDER: Il?/?\'`V-^I )'l PROVIDER: l f/"ICC.?I?I1 ?•I ESTIMATED COST OF CONSTRUCTION:
(M MAT NG LAND VALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DMET ,I (? /]
OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE): _ -
l J LLPE P-(O0 /t
EX` -
NUMBERS; TAC DATE(S); ANDI l
-
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY: X TAX MAP PARCEL 0:
f - I O ` 4 L-
-
TYPE OF CONSTRUCTION:
0>-SINGLE FAMILY
? TOWN HOME
Cl TWO FAMILY
# of units being
constructed at this
time.
? RESIDENTIAL (For
Additions. Remodels, Etc.)
PROIECTINFORMATION:
Early Release
Permit: Y N
Lot Split: _Y t'N
TYPE OF IMPROVEMENT:
C??NEW STRUCTURE
? ROOM ADDITION(S)
? PORCH ADDITION(S)
? DECK ADDITION(S)
? REMODEL
_ Basement Finish only
? ACCESSORY BUILD"
M DETACHED GARAC
? ATTACHED GARA(
? DEMOLITION
PLUMBING CONTRACTO U
Plumbers Indiana State Li #: -
Which plumbing codes will be a - -
Q-Intemational Residential Code w/Indiana Amendments
11_!'q'fpnn Plumbing Code w/Indiana Amendments
/6rs . ? O C.•.
Manufactured ? r+/?? pT,
Trusses: Y11QQ ' r OF
Sump Pump: ? Y _N
(Check all that apply for the new
BEAM -PIER
_Y_N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures s "{•i?• }fTi?(?tpp[ctt??ction commences within ISO
days of the date of issuance of the building permit, and must be completed (Certificate of Okxupancy jd) wi ntF?f the issuance date. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 LAC 12) regarding a lj,yre frames for beginning and
completing construction /I++
1, the undersigned, agree that ar-y construction, recon<_trucdon, enlargement, relocation, or alteration of a structure, or ar-y change in the use of land or structures
requested by this applicatior will comply with, and conform to, all applicable laws of the State of Indiana, and the `Zoning Ordinance of Carmel Indiana -1993" (2-
239) 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
lutcher,,bath, and ffloordmins are connected w the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
OccuOamcyhaSbeen i a Dep f Community Services, Cazmel, Indiana-
I AA
l(^t??J??14(L^LaFVV%AAyll
l.OAMOF HPt"+FXO 1 7 0 7
Sio.tu Owneror Authorized ent Print Date
DFFIC SE ONLY:
*+•*ssssss:*::s:xs:s*:.*+a+**sssxsxs+e::.*¦axxsxsa**:? : Jrssssass:s**a«.*:ssaa
Filing Fees:
INSPECTIONS REQUIRED: tions:
I
B x Charged Re-
pper Fo ting wer Footing Under Slab ase
nspec
S SD Reviews
Cert. of Occupancy:
ug n 11aFinal Site
ete
1 / ?
: l (7D
P
R
I
F
Additional Fees
7 .
.
.
.
TOTA
L
.
^
?y
Reviewed/Approved: Dept. of Community Services (Date) 4'(
S:Peon!:W mIrLP RESIDENT, Fee Received by: