HomeMy WebLinkAbout05120033-ApplicationCity of Carmd /Clay Township ~ permit #:
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUZLDER of
RECORD:
OWNER:
LOCATZON
S~EET ADDRESS . ~ ~ ~/ c~rf STATE zip
& PRO3ECT
ZNFO:
LOT # SUBDWISION NAIRE SECTION
ADDRESS OF CONSTRUCT1OI~'
~ SINGLE FAMILY ~ NEW STRUCTURE
[] TOWN HOME [] ROOM ADDITION(S)
[] TWO FAMILY [] PORCH ADDITION(S)
# of units: [] REMODEL
~] MULTI-FAMILY [] ACCESSORY BUILDING
# of Units:
[] RESIDENTIAL (For []
Additions, Remodels, Etc.)
SQUARE
EST~MAI'~D COST OF CONffl~UCTION:
(EXCLUDING LAND VA~UE)
'--: ' = ,RHA :
Early Release
Permit: Y
Lot Split: ----Y --~N
Does any part of the property lie within a.,
Plumber's Zndiana Sh,te
Which plumbing codes will be
~Zntemational Residential Code w/Zndiana Amendments
[] Uniform Plumbing Code w/Zndiana Amendments
(MulU-Family Construction Code)
r:~[J~~: (check all that apply for the new
construction area)
Y WALKOUT:
Fo~ tS~.Z~ oF ~,,y a.n ,d T ,wo F .a~fl.' y dwellings, add. i~.ons, rem.odds, and/o~ accesso r:j~-9~f rur es, this permit is valid onfy if construction corranences
· re, thin.18 .y,s ot the aate of xssuaTqce of the building perrmt, and must be compl~.~f~'~certificate of Occupancy issued) within 18 months of the
issuance gate. Class I structure perrmts are subject to the General Admh~trative ~$~ tbe State of Indiana (See 675 lAC 12) regarding expiration
time frames for l:~glnning and complerifi~onstruction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alretatinn of a structure, or any change in the use of land or
st~..cmres ~u~ ested by tbs application will comply w~th, and conform to. all applicable laws of the State of Indiana, and the 'Zoning Ordinance of Carmd
Imliana - 1993 (Z-289) md amendments, adopted under authotit-/of I.C. 3&7 et seq, General Assembly of the State of indiana, and al/Acts amendatory
thereto. I furth, er. cer~., that o~.y kitchen, h~th, and floor drab? are connected to the sanitary sewer. I further certify that the construction will not be
usea o~/occupled un~til a. ~Cerchqcac~e of OccJ~Aoc?has been ~ssued by the Department of Community Services, Carmel, Indiana~
Sillna~re~ Owner or A~hmize4 ~gen~ (/ - Print (d
OFi~CE USE ONLY: ****************************, ~ ****************~ ***~r~5.~ **~,,,.j~. **************
/ /' /~¢/ Filing Fees: / O ~ ~,
S . : # CRh~vrige~sRe '
Final Site
P.R.I.F.: _..~ C/:~ Addit,on~l Fees
Reviewed/Approved: (Date) '