HomeMy WebLinkAbout07120070 ApplicationV 7 0
Permit z:
City ofCarmel/Clay Township
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
a iaNa j For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME PHONE: FAX:
OF ?G,S?n L }Ind t es ( Lc; 312- 7D - )70 0 -
RECORD: STREET ADDRESS: CITY: STATE: ZIP:
)I 0 iz- W, n :u w 1-16 0?4
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
Fr e?l?v: l¢ J }al!e ho a5. a.--:l a?_ f,..x
PROPERTY NAME: PHONE: FAX:
OWNER 0,Q) Aiz.Joa 3l? -17z1 3S2
:
CITY:
STREET ADDRESS: STATE: ZIP:
,1?
gj'ys /V;c ego- z tl /3-
LOCATION LOT #: SUBDIVISION NAME: SECTION: ZONING: /?
PROJECT vl I OF UgOr c 1. ?laz ks yUQ
&
INFO: ADDRESS OF CONSTRU/C?T?yOyN?: rh
rZ4
3
L SQUARE
FOOTAGE:
'a.: C L
ib d.
SEWER LITILTTY WATER LMLn)z?} O'J J? Q(J?9 ESTIMATED COST OF CONSTRUC TION:
PROVIDER:
G c
t PROVIDER: /' ---7?-
4 r.. (EXCLUDING LAND VALUE) ,? eT J
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / / BPW DOCKET
(IF APPLICABLE):
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PE A I S?• 2/)i l Z
/
FLOOD ZONE AREA DESIGNATION(S) X TAX MAP PARCEL #:
FOR THIS PROPERTY: /
TYPE OF CONSTRUCTION:
SINGLE FAMILY
O 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
YPE OF I R V ^ T: V
N UCTURE? J 1 ZQO j
'Nr
O ROOM A ON(S)
? PORCH ADD S)
D DECKAODTTION(
O REMODEL
_ Basement Finish only
D ACCESSORY BUILDING
? DETACHED GARAGE
? ATTACHED GARAGE
? DEMOLMON
Manufactured
Trusses:
Sump Pump:
State Licensl #:
Arhich plumbing codes will be applied to the construction:
O International Residential Code w/Indiana Amendments
1E? Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
N O CRAVJLSPACE ? POS;Ar & _ BEAM -PIER
-jy -N SLAB 121 VSEFIEt flUi:_Y?_N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this perfntt is valid only if construction commences within 180
days of the date of issuance of the buildutg permit, and must be completed (Certificate of q , issued),witl°iin IS months of the issuance date. Class I
structure permits are subject to the General Administrative Rules of the State o(Indi 6i5 ; C;12)?egaxdlmg expiration time frames for beginning and
completing constru "o ci?
1, the undersigned, agree that any cons:nxtion, reconstruction, erla:gement, relocation, or a tion of a structure, or any change in the use of land or strucmrs
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the Zoning Ordinance of Carmel Indiana-199Y (2-
289) and amendments, adopted under authonty, of I.C. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amends:oryy thereto. I further certify that only
luachen, bath, and floor drains are connected to 6e sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occu cvhas Ix v the Department of Community Services, Carmel, Indiana.
signature of Owner or Authorized Agent Print pate
OFFICE USE ONLY: xxx***x*x*****xxx***xx*xxxxxxxx****x****x*xxx*x*xxx**xx***xxxx**xx**xx*xxxx*xx***
INSPECTIONS_BEQU?IRED: Filing Fees: I n4 - 7??
``??JJn! Base Inspections: a"S - 50 # Charged Re-
er Foo Cower Foot' Under Slab Reviews
°
PP 0
Cert. of Occupancy:
ough In Meter Ba Final Site P. I.F.: 1 a CD 1 00 Additional Fees
OT li Ip 1
V -7
Revieweda Appr ved: Dept. of Community Services (Date) JA
s:Pemdts(Farmsr:LP aesoF:mAL Fee Received bv: Date