HomeMy WebLinkAbout05120070-ApplicationCEy of Carmel/Clay Townskip ~Permit: #
IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, HuRl-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
E-- ~-- PHONE ~ FAX
RD: s-m~ET A~OReSS crrr STA~ z~e ]
PHONE FAX
OWNER: q ~-[ ~
STREET ADDRESS CITY STATE ZIP
.OCATION SeCnON
& PRO3ECT
INFO: ~ESS
ST OF CONSTRUCTION:
J NANE OF LrTiLITY EXCAVATION CONTRA~CE; PLAN COMMISSION J BZA / BPW DOCKET ~ ~ j,^
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE): r~l/~
- F = - . -i:
~ SINGLE FAMILY
E] TOWN HOME
[] TWO FAMILY
# of un,s:.
[]] MULTI-FAMILY
# of Units:
[] RESIDENTIAL (For
Additions, Remodels, Etc.)
P TN RMATZ 1:
Early Release
TYP :F:, -:-:- VEM .:
[] NEW STRUCTURE
J~. ROOM ADDITION(S)
~ PORCH ADDITION(S)
[] REMODEL
[] ACCESSORY BUILDING
[] DETACHED GARAGE
[] ATTACHED GARAGE
[] DEMOLITION
Manufactured
Plumber's Tnd
Which
~.~nt~maUonal Residential Code w/Indiana Amendments
O Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
F - - D- I -= -- : (Check all that apply for the new
construction area)
[] BASEMENT
N WALKOUT: Y Pq, N
For Single Family and Two Family dwellings, additions, remodels, and/or aecessory structures, this perr~t is valid only ff construction commences
within 180 days of the date of issuance of the building permit, and must be co~j~.~t~ {~.~eatc of Occupancy issued) within 18 months of the
issuance date. Class I structure ~ermits are subject to the General Administrati{;~ ff[~l~£~
tLmc frames for begiunmg ~
L the undersigned, agree r~c a~
will not be
OFF[CE USE ONLY: ************************************************************************
· ng Fees:
ZNSPECTIONS REQUTRED. n~{L(~F ~ - --
) ........ ~S'~ Base Inspections: ~ # ~ar.ged
tower rooting unaer alan -;-~ I ~--'/-~ Kevmws
Cert. of Occupancy: ~
Meter Base P.R.I.F.: AddlUonal Fees
TOTAL: