HomeMy WebLinkAbout07120100 Applicationr tiM?,
City of CarmdlCtay Township Permit #: o'7 100
j RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAM PHONE, FAX.
' 17 9?4 l3 31? 9 t/(o-1
17
'
OF
?S v
C
,
.
RECORD: STREET ADDRESS:
/08S0 moo C'D 577 C-x CITY: STATE:
CAe-rn EL =-,- 4- ZIP:
&0-1.2
IL
ER's EMAIL ADDRESS:
BU
D BEST METHOD OF CONTACT:
?
.
?
1 /J 4T7-, v F-7-
PROPERTY
OWNER: NAME,
3C-P /27,6 yy-=lL PHONE: FAX:
7 os - o l g i
STREET ADDRESS:
/ 3?a 3 ,? Z AN, rL- C,',e (1 l,C CITY: STATE:
C1q0E.-n e- r _a7?d ZIP:
'160 33
LOCATION LOT t; SUBDIVISION NAME: SECTION: ZONING:
& PROJECT '!FM ??/¢!d G'R_ 0-?/ 2L t?px
INFO: ADDRESS OF CONSTRUCTION:
J ?.2 3 //?.v zA,,, C, 2 Jar C 1 FOOTAGE:
SEWER UTILITY WATER UTILITY ESTIMATED COST OF CONSTRUCTION:
PROVIDER: 2„?
<, / PROVIDER:
L (EXCLUDING LAND VALUE)
7?lt F
7
, [
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / 8ZA / BPW DOCKET `
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL
FOR THIS PROPERTY:
O SINGLE FAMILY
O TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
RESIDENTIAL (For
Additions, Remodels. Etc.)
PROJECT INFOR MATION:
Early Release
Permit:
Y ?N
Lot Split: _
_Y v""N
For Single Family and
structure permits are subject to the
PLUMBING CONTRACTOR: IMY l
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
O International Residential Code w/Indiana Amendments
Uniform Plumb mendments
RE?E :?1?d4s?t dq& apply for the new
Subjec CIS q'iral cods
IRS BEAM -PIER
DEPT 21a?nst?a?stOWK JT: Y N )
be completed (Cez
ules of the State of
ruction commences within 180
s of the issuance date. Class I
time frames for beginning and
I, the undersigned, agree that any construction, reconstruction, enlargemtnt, relocat?il?ti]ts?tu?u cgein tie 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-
289) and amendments, adopted under authority of LC_ 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. 1 further certify that the construction will not be used or occupied until a Certificate of
0 cyhas been issued by the Department of Community Services, Carmel, Indiana.
0
? ?''i ?b n.n.ta-?n / O h? rl ASS • o .J
Siganttire of Owner or Autlrorixed Agent Print Date
OFFICE USE ONLY:
INSPECTIONS REQUIRED:
Upper Footing Lower Footing
Reviewed/Approved: bit" Community Services
S:Perm1ts/Foms9LP RESIDENTIAL
O NEW STRUCTURE
O ROOM ADDITION(S)
O PORCH ADDITION(S)
O DECK ADDITION(S)
REMODEL
_ Basement Finish only
O ACCESSORY BUILDING
? DETACHED GARAGE
O ATTACHED GARAGE
? DEMOLITION
Manufactured
Trusses: _Y `N
Sump Pump: i/Y _N
Filing Fees:
Slab Base Inspections:
Cert. of Occupancy:
Site
P_R_i_F.:
********************
# Charged Re-
Reviews
-? Additional Fees