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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)