HomeMy WebLinkAbout07120079 Application- ktimc7R L?) "4140 ?71
Permit #.
City of Carmel/Clay Township
RESIDENTIAL IlVIPROVEMENT LOCATION PERMIT APPLICATION
alFa For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER VE. PHONE: FAX:
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RECORD: STREET ADDRESS: CITY: STATE:
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BUILDER'S EMAIL ADDRESS: BEST METHOD OF CO ACT:
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PROPERTY NAME: PHONE:
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OWNER: r 3/7- o
STREET ADDRESS: CITY: STATE: ZIP:
lo,yl G ? title t m e/ _Tw `r4&0
LOCATION LOT U: SUBDIVISION NAME: SECTION: ZONING:
& PROJECT 3 'q &L rot 4L 'IN ' o a
INFO: ADDRESS OF CONSTRUCTION:
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SEWER UTILITY
PROVIDER:
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. WATER UTILITY ESUMATED CO67 OF CONSTRUCTION: /
PROVIDER: CaM1 e1 (.?ar,'Iei (IXCLUDING LAND VALUE) Yr ? p0
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4 .
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NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
ANDIOR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICA
S)
TAC DATE
S
BLE):
(
NUMBER
; ;
FLOOD ZONE AREA DESIGNATION(S) / O I 0.2"GC r
FOR THIS PROPERTY: Z
e Y TAX MAP PARCEL #:
DEC 17
On
,
TYPE OF CONSTRUCTION:
O SINGLE FAMILY
? TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
RESIDENTIAL(For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit: _Y _N
Lot Split: _Y ?N
TYPE OF IMPROVEMENT:
O EW STRUCTURE
ROOM ADDITION(S)
O PORCH ADDITION(S)
O DECKADDrnON(S)
? REMODEL
_ Basement Finish only
D ACCESSORY BUILDING
O DETACHED GARAGE
O ATTACHED GARAGE
D DEMOLITION
Manufactured
Trusses:
Sump Pump:
___Y I' <
_Y ??
PLUMBING CONTRACTO : I hfI?
Al /q By ?---
Plumber's ndiana State License #:
Which plumbing codes will be applied to the construction:
O International Residential Code w/Indiana Amendments
O Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Chedc all that apply for the new
construction area)
CJ ?RAWLSPACE u POST & BEAM -PIER
SLAB? ? BASEMENT (WALKOUT: _ YN )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if con c en s within 180
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within III??? ante daze. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 LAC 12) r a ames for beginning and
completing construction.
1, the undersigned, agree that any construction, mcon=_trucdon, entargemcmt relocation, or alteratio .ange im the use of land or structures
requested by tiffs application will comply with, and cwnfom :o, all applicable laws of the Sure or Indian t -coning Ordinance of Carmel Indiana -199r (2-
289) and amendments, adopted under authority of LC. 36-7 et seq, General Assembly of the State of India and all Acts amendatory thereto, I furthereertify that only
kitchen, bath, and floor drams are connected to the sanitary s er. I further certifv that the construction will not be used or occupied until a CerOB"te of
O p eyhasbeenissu ythe DeDe tment of 'ty Services, Carmel, indium
cilll? ownerm AUthorizM Dent '// Grim Date
OFFICE USE ONLY: xxxxxxxzzx***xzxzx***xzzzxxxxxzx**xxzxx**xzzxx**xxzxxxxxxz***zz***xz****zxx**xxxz
INSPECTIONS REQUIRED: Filing Fees:
Base Inspections: 1 0 # Charged Re
It6per Footin ower Footi ng nder Slab Reviews
Rough In eter Base Final Site
Reviewed/Approved: Dept of Community Services (Date)
S:i'ermlJ/FarmylLP RESIDEh IAL
Cert. of Occupancy: -5::j. --,0
P.R.I.F.: Additional Fees