HomeMy WebLinkAbout07110176 Application7
City of Carmel/Clay Township Permit #:
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home & Two Family: New Structures, Additions, Remodelsr & Accessory Structures
.waiaHome, BUILDER NAME: PHONE: FAX:
Zc%/cY ?cr+SE?u?fiov,, ln?. 9y3-?34Y 943-9381
OF
RECORD: STREET ADDRESS: CITY:
5 y,5b W od A'elcl Wo4j STATE: ZIP:
//V V6o33
BUILDER'S EMAIL ADDRESS:
-ro? Ze l l e l-S 56C /o 60. /7 t!- BEST METHOD OF CONTACT:
?/?•+a+ 1
PROPERTY NAME' PHONE:
5 CG A FAX:
OWNER: /7,c-
STREET ADDRESS: _-? CITY: STATE: ZIP:
LOCATION LOT:: SUBOIVISION NAME: SECTION:
3 ZONING:
PROJECT Wi ndio? rOV (
&
INFO: ADDRESS OF / CONSTRUCTION:
/l ?'la'! /_I__?S?- ,L
JT L? SQUARE
FOOTAGE:
SEWER UTILITY
I WATER IfTI
? // D 7
PROVIDER:
/ / J
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) (/Oj
OJD
O7
PROVIDER: Cj P-W
L)
_
., l
t
/
.
r 7L) 1
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
' V ?J„
G xe (
-
OR COUNTY WELL ANDIOR SEFrIC PERMIT *'S (IF APPLICABLE): H/ C Lo-L
TE
AND
T
C D
S
(
NUMBERS;
A
A /
); /- A
1 y,
A
ROOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL #:
FOR THIS PROPERTY: / I/O
J
TYPE OF CONSTRUCTION:
X SINGLE FAMILY
O TOWN HOME
O TWO FAMILY
tf of units being
constructed at this
time:
0 RESIDENTIAL (For
Additions, Remodels, Etc)
PROJECTINFORMATION:
Early Release
Permit:
Lot Split:
_Y ?N
Y _N
TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR: (_V? In
NEW STRUCTURE sloe 7L JV?I in)
O ROOM ADDITION(S) plumber's Indiana State License ? Q 200]
O PORCH ADDITION(S) /C/ X108
O DECKADDITION(S) / IC
O REMODEL Which plumbing codes will be applfe
_ Basement Finish only
O ACCESSORY BUILDING 'KIntemational Residential Code w/Indiana a ents
O DETACHED GARAGE ? Uniform Plumbing Code w/Indiana Amendments
O ATTACHED GARAGE
O DEMOLITION FOUNDATION TYPE: (Check allL ly for the new
Manufactured / construction area) „?Jv\¢`dR99
Trusses: _Y N Q CRAWLS Q? \\P.O'e & WM-PIER
Sump Pump: ?Y_N C),"O4SgEEMENT'(WAL ,.a N)
_G ?,btjgtl?r4UpY commences within 180
rd orml
For Single Fanulq and Twro Family dwellings, additions, remodels, and/or accessory
days of the date of issuance of the building permit, and must be completed (Certificate ?Yf thfa'YB o the issuance date. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana ee fi75IA g,exp !{9P time frames for beginning and
completing construction.
I, the undersigned. agree that any mnstnacdon, reconstruction, enlargement, relocation, o- after f a,. . oral ?mge in the use of land or structures
requested by this application will comply with, and conform to, all applicable la-.vs of the State of??ItrgJiAt(a?afr)I the "Zoning O: Ix.ance of Carmel Indiana -1993" (Z-
2E9) and amendments, adopted under authority of I.C. 36-7 et seq, General Assemhly of the State Qy m-ana, and all Acts amendatorythereto. I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Ce 'Beare of
occupancy - been issued by the Department of Community Services, Carmel, Indiana. 11
Signature of Owner or Auth Agent Print /
******xxx****xxxsx**xx**x******x****x******xx****xxx***********x****x*x****x*****
OFFICE USE ONLY:
INSPECTIONS REQUIRED: Filing Fees: S. D
Base Inspections: # Charged Re-
Upper Footing ower Footing Under Slab Reviews
----- Cert. of Occupancy: S S d
ough in eter Bas Fi?Lyal?Sfte ) /
P.R.LF.: Ot l+ Additional Fees
?p
C raL -,Qj r 11-10-07
Reviewed/Approved: Dept. of Community Services ( ate) ?? f?i!
S:PermIWFMn'.s/IL RESIDENTIAL Fee Received