HomeMy WebLinkAbout07120068 Application?urena?
Permit #:
City of Carmel/Clay Township
'i. RESIDENTIAL HVIPROVEMENT LOCATION PERMIT APPLICATION
potp?, j For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME: ? PHONE: FAX:
1 veY50v) 3(1-`(89-ScnO
OF
RECORD: STREET ADDRESS: Z??1 n \?? ?y CITY: ( , , ,r.-del STATE:-TA) ZIP: 41,0) Y
BUILDER'S EMAIL ADDRES . sf'-oI VWw"3 BEST METHOD OF CONTA
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PROPERTY (?
NAME: wI ?f V50PRUNE. i ` U FAX:
31l -9q`t-59?
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OWNER , , e
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STREET ADDRESS: CITY: STATE: ZIP:
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LOCATION q
LOT SUBDIVISION gje t C II_ZC ? TRUC7ITUN'
S9 CITY th all regulati ZONING:
& PROJECT on-
INFO: ADDRESS OF CONSTRUCTION: T
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FOSQUARE
OTAGE. It112
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SEWER UTILITY
PROVIDER: ?
l NSfRUCTION:
WATER UTILITY
PROVIDER: c
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NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET N
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #5 (IF APPLICABLE):
/1 r
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E X1-5 I? I
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PAR
I n
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
O SINGLE FAMILY
O TOWN HOME
? TWO FAMILY
# of units being
constructed at this
time:
? RESIDENTIAL (For
Additions, Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
Y --?4'N
Y -;? N
TYPE OF IMPROVEMENT:
Ge NEW STRUCTURE Iq
O ROOM ADDITION(S)
O PORCH ADDITION(S)
O DECI(ADDITION(S)
(Er- REMODEL
P!Basement Finish only
CD ACCESSORY BUILDING
? DETACHED GARAGE
? ATTACHED GARAGE
0 DEMOLITION
Manufactured
Trusses: Y ?N
Sump Pump: Y N
Ll, 1 4 IUU/
Indiana
Whi to ing codes will be applied to the construction:
O In 'onal Residential Code w/Indiana Amendments
C) Unitty robing Code w/Indiana Amendments
(Check all that apply for the new
GI CRA1 I ACE ? POST & _ BEAM -PIER
O SLA?-- BASEMENT (WALKOUT:_Y--X-N )
For Single Family and Two Family dwellings, additions, remodels, and'or accessory structures, this permit is valid only if construction commences within 180
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within i8 months of the issuance date. Class 1
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
completing construction.
I, the undersigned, agree tha[ any cons 'aon, reconstraction, enh genier ?t, relocation, or alteration of a structure, or any change in the use of land or structures
requested Irv this applicationtan c ply with, and conform to, all applicable'laws of the State of Indiana, and the "Zoning Ordinance of Carmel Irdiana -1993 (7-
ill
289) and amendments, adopted der 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
kitchen, bath, and floor drains connected to the sanitary sewer. I further eett?Iy that the construction will not be used or occupied until a Certtftpre of
Omu cyh \been issued the Depart entof Cam numty?es, Car`l, Indiana.
<zil / LrWd? 14 f3 t»l
signature of owner or Aulhorimd Agent t Date
r1CCir'C Imp nail v ###
Final
Upper
5:PamRs/FarmsALP
Filing Fees: !y,(iV T- / 3d ?V - u/ C,
Base Inspections: / ?) # Charged Re-
Slab _ Reviews
Cert. of Occupancy: S SG'
alto D D T G • - Additional Fees
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Fee Receivec bv: ate