HomeMy WebLinkAbout07120067 Applicationf? 1
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City of Carmel/Clay Township Permit #: Dr2) 2On0
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF NAME: [ PHONE' FAX:
? ?-t ?.?'?lc.iM- `(3 ? S?f? - 2-070
RECORD: STREET ADDRESS: CITY:
!S`j ? ?'?' ?edco STATE:
CP, r oyl .?W- ZIP:
Ai&n30
E nlcl,t BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
11chC? d?.?v'dl ®??KI
PROPERLY PHONE: FAX:
NE'
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OWNER
:
STREETADDRESS: CITY: STATE: ZIP.
LOCATION
PROJECT LOT:: SUBDIVISION NAME:
70 [Q o ?-5 SECTION:
SOO l ZONING: `
pu eK
&
INFO: ADDRESS OF CONSTRUCTION:
la? S ?f'S'lNn/ ?%- r
tic Y FOOOT GE.
qlq $3
SEWER UTILITY
-
I O -12.00 bhp
WATER UTILITY
- ESTIMATED COST OF CONSTRUCTION:
EXCLUDING LAND VALUE)
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PROVIDER: C
R l? ?
PROVIDER: ? _9 rn'
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000
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
OR SEPTIC PERMIT #S (IF APPLICABLE):
WELL AND
T
/
NUMBERS; TAC DATE(S); AND/OR COUN
Y
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL #: D I
FOR THIS PROPERTY:
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TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR: I II I DE
14 01 U
l
SINGLE FAMILY ? NEW STRUCTURE L
TOWN HOME O ROOM ADDITION(S) "
gle6n7nLi
O TWO FAMILY ? PORCH ADDITION(S) ?
?
P
ll
4
# of units being O DECK ADDITION(S) u
constructed at this O REMODEL Which plumbin g codes will be applied to thion:
time:
O RESIDENTIAL (For _ Basement finish only
O ACCESSORY BUILDING ?,
x1ritemational Residential Code w/Indiana Amendments
Additions. Remodels. Etc.) O DETACHED GARAGE O Uniform Plumbing Code w/Indiana Amendments
O ATTACHED GARAGE
PROJECT INFORMATION: ? DEMOLITION FOUNDATION TYPE: (ChectOthat apply for the new
Early Release
Y 0
Permit: Manufactured ?
Trusses: construction area)
BEAM -PIER
%ET &
CPA '
01
_
Lot Split: _Y - % Sump Pump: ,
_
ffi. f?TI C ,-Y N )
ta1
For Single Family and Two Family dwellings, additions, remodels,
days of the date of issumcc of the building permit, and must be c
structure permits are subject to the General Administrative Rules
Wtion commences within 180
s of the issuance date. Class 1
time frames for beginning and
completing com;yWt9on. s'^G G" 1 P.
1, the undersigned, agree that ariv construction, reconstruction, enlargement, relocation, or ahera?+ a -r ?€, prsR c ange in the use of land or structures
requested Sy this application toil! comply with, aid conform to, all sppliable laws of the Stxlq 11thq' ng Ordinance o; Carmel Indiana-1993" (Z-
289) and amendments, adopted under authority of LC. 36-7 et sec, General Assembly of the?ka???16K iana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains as connected to the sanitary sewer. I further certify thaz twction IN not be used or occupied until a Certih'cate of
r_ mumtyServices,Ca el. Indian
occupancyhas asst: yt e m
Y. 2 /
4c) r-0,-J -re-- 1311 "Ito -7
Sigluture of Owner Sr AUMwIZeA w9enr Print Date
******************.+**:**************.************ * * *:******.r*************
OFFICE USE ONLY:
INSPE QUIRED: Filing Fees: 930
Base Inspections: # Charged Re-
pper oo in Lower Foot! der-Slab Reviews
Cert. of Occupancy: 5 5t
ough In Meter Bas Final Site
P.R.I.F.: 1 oc10 I .00 Additional Fees
OTAL:
6-7
C j
Reviewed/App: ve : Dept. of Community Services (Date)
S: Perml[si Fartns/ILP ESIDENTUL
Dake