HomeMy WebLinkAbout08010066 ApplicationR City of Carmel/Clay Township Permit #: G
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
wpIA„a , ` For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF NAM ' _
., I
L [A Qvll L PHONE: FAX:
J 7J J? JC.) J- 0(4-11
RECORD: STREET ADDRESS:
1 l J G
Y11 " 1 A CITY: STATE: ZIP:
t J ST C?1 l -kl -L r co 0? 2
BUILDERS EMAIL ADDRESS:
OA M HLPHEOL?) BEST METHOD OF CONTACT:
6? PICT = rtr 1` to ( L,
PROPERTY NAME. PHONE: FAX:
OWNER: tit
STREET ADD CITY: STATE: ZIP:
LOCATION
& PROJECT LOT #:
LC1 0 SUBDIVISION NAME:
- N - i2 V, S71S
. L I Al _ S
ZONING.
i
INFO: ADD
RESS OF CONSTRUCTION:
1W A kCA I) A
P-Gt' E-
SQUARE
?
FOOTAGE:-
SEWER UTILITY
PROVIDER: l
(
l WATER UTILTTI
PROVIDER: ESTIMATED COST OF CONSTRU ON:
(EXCLUDING LAND VALUE) I r (2-
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE): Q _ L F 0 r` ?? x C
1
FLOOD ZONE AREA DESIGNATION(S) 1
FOR THIS PROPERTY: 11 -. - CTRUC-T10 I
^ r r f' Ions TAX MAP PARCEL *:
-Z 10 - ZZ- DU 0'3(0
r
&--"SINGLE FAMILY
O TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
0 RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release ?/
Permit: _Y _N
Lot Split: _Y
GI V
O
O
O
O
_ Basement Finish only
ACCESSORY BUILDING
DETACHED GARAGE
ATTACHED GARAGE
DEMOLITION
Manufactured
Trusses: -Y _N
Sump Pump: ?Y _N
Which plumbing co(
3? lntemational
FOUNDATION TYPE: (Check all that apply for the new
construction area)
O CRAW LSPACE O POST & _ BEAM PI F
? SLAB Ca-BASEMENT (WALKOUT: YN
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences 14thin 180
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 IAC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, re'.ocat!on, or alteration of a structure, or any change in the use of land or structures
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 -1993" (2-
269) and amendments, adopted under 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 Poor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
??- ,,????_ ? ??i 1?.?c1 ? 1(?ANN? S HE P?Lt? 1 ? DS
nature-n ? or Authorizes AaAnt Print ° DN(a
ONLY:
TIONS REQUIRED:
Lo er Fo g n
Filing Fees:
Base Inspections:
Cert. of Occupancy:
P.R.I.F.:
'y ! 1
7 o # ChareVgiem
Additional Fees
.3
Reviewed/Approvea""TSept. of Community Services (Date)
S_PerrNWFOrMVILP RMDENTLAL Fee Received by:
? Uniform Plumbing Codew/Indiana Amendments