HomeMy WebLinkAbout05110164-Application· City of Carmel~Clay Tomashi£ perm,t #: ~ wu - ~ - /
RESIDENTIAL IMPROVEMENT LOCATION PERIVIIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & AccessoW Structures
BUILDER of
RECORD:
PROPERTY
OWNER:
NAME
~ - : - ---_,$
STREET ADDRESS
BUILDERS EMAIL ADDRESS
NAME
h, c
STREET ADDRESS
PHONE FAX ~
Cr~Y STATE ZIP
LOCATION LOT # SUBDIVISION NAME
& PRO3ECT '
ADDRESS OF CONSTRUCTION
NAME OF LFI3LIT~' EXCRVATION CONT~GOR; P~N COMMISSION B~ / ?W ~CK~
NUM~; TAC DA~(S); ~D/OR COUN~ WELL AND OR SE~C PERMg ~ S (IF APP~BLE):
SECTION
--/' ZONING:5'-- Z.
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
TYPE F ON R CT[ N: TYPE OFIMPROVEMEN : 9 9
~ SINGLE FAMILY []] NEW STRUCTURE
~ TOWN HOME ~ ROO~ ADDITION(S) P umber'B
{~} TWO FAMILY ,,,~-~:~ ......... ;,;
O MUL~-FAMILY ~' ACeF~gORV ~[~ Which plumt
~ofU~i~: :: ::~: ~'~]~E- ~ ~nternatona Resdenta Codew/IndanaAmendmen~
Addtons Rem~e~/~ ~ ~ ~' '~.~[~ ~ ~ Unifo~PlumbngCodew/IndianaAmendmen~
' ~T~ ~:: ,./~ ~ ~[~0~ T(]V~]~ (Multi-Family Con~u~ion Code)
P - ~ INF RMA N: j:-
~ ~ FOUNDATION ~PE: (Check all that apply for the new
Early Relea~ ufa~umd
Permit:
/ ~ C~WLSPACE ~ POST & B~H
Lot Split:
~es any pa~ of ~e prope~ lie within a special Flood designation area~ WALKO~:Y~
~ot Single ~y ~d TWo F~ily ~w~i~gs, ~ditio~s, removals, ~a/ot ~cc~so~ s~ct~tcs, t~is p~mit Js
~t~n 180 days of the date of issuance of the building per~t, and must be completed (Certificate of Occup~cy ~sued) within 18 months of the
issu~ce date. Class I structure permits are subject to the General AdminNtrative Rules of the State of lndi~a (See 675 lAC 12) regarding e~iration
rime frames for beginning and completing construction.
I, the unde~igned, agree tha~ any conscrucuon reconst~cuon enlargement, relocation, or ~teration of a st~cture or ~y c~nge in the use of ~d or
s~cmres requited by ~Js application ~v~ comply ~th, and co~orm to, ~ apphcable laws of the State of India, and the Zomng O~ce o[ C~md
India - 1993 (Z-289) ~d amendments, adopted under authority o[ LC. 36~7 er seq. General Assembly of the State of India. and ~ Acus amendato~
the~to, i ~rther certify that oNy l~tchen, bath and floor drams are ;onnected to the samca~ sewer. 1 further certify t~t the const~ction will not be
u~d or occupied until a CeetJ~cate o/'OccupancZ ~s been issued by the Department of Community Semites. C~meL [ndNna.
USE ONLY; ********** ***********************--*****
OFFICE / /'5"
~ ...... ~"lns~ions:/~u~
Lower Footing U"d~ ~{~ /~ .~ Rev*ews
Ce~. of Occupant:
Meter Base P.R.L =.: AOOit~ona~
~ TOTAL: '
R~~~7 (dam)