HomeMy WebLinkAbout05120140-Application
City of Carmel/ Clay Township lY & ~ Permit #.()5/ ;(O / LfD
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
TYPE OF CONSTRUCTION: VEMENT:
o SINGLE FAMILY . , fW STRUCTURE
o TOWN HOME ,.xc (Q)~ ROOM ADDmON(S)
o TWO FAMILY -{\ S O~CH ADDmON(S)
# of units: ~ ~ tJ ODEL
o MULTI-FAMILY y' )f\; ACCESSORY BUILDING
!:J!....of Units:~ \ (jtJ DETACHED GARAGE
o ; ~llil~I'iTlA~~I?Et( 0 ATTACHED GARAGE
8~~~e ,EtcS )"d DEMOLffiON
P ECT
" iteQas/l.atoaf)(jf) With S7'~ctured
e dii\l:'C l,'O~V.OC"'1t <l111'if/ij1fl~tv _Y _N
'A.A/I;f,::'VVNI'1"\rQ o(je litlo,,_ 0 CRAWLSPACE
Lot Split: ~cr-;;;:'S ~umpPltll1p: _Y _N 0 SLAB
Does any pa ~ {i . a special Flood designation area: Y N
For Single Family and Two Family dwe ~itions, remodels, and/or accessory structures, this permit is valid only if construction commences
within 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
time frames for beginning and completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the 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" (Z,289) and amendments, adopted under authority of I.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. 1 further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I funher certify that the construction will not be
~;: ~~CYhAs beeni=eN~~~~::nt o~~~~semces. Carmel. Indiana, \ L- ?;{ -ffi
Signature of Owne~ o~ AL.thorlzed Agent U Print -- -I 0 Date
OFFICE USE ONLY: ** ********** ******* *** ****.~**** ***** *** *******)f *&*~** * * *** **** *** ******
Filing Fees: Il2(.d..I L;:;
INSPECTIONS REQUIRED: - 5
Base Inspections: 5..'3. 0 # O1arged Re-
" Reviews
Cert. of Occupancy:
BUILDER of
RECORD:
NAM
b.,lA~-llcV./\./.L.
(CCL-nLf
PROPERTY
OWNER:
NAME
~\X)lJL,
STREET ADDRESS
LOCATION
&. PROJECT
INFO:
LOT #
'2-
ADDRESS
SEWER UTILTTY
PROVIDER:
NAME OF UTILTTY EXCAVATION CONTRACTOR; PLAN COMMISSION i BZA i BPW DOCKET
NUMBERS; TAC DATE(S); ANOIOR COUI'ITY WELL ANOIOR SEPl1C PERMIT #'S (IF APPUCABLE):
Upper Footing
Lower Footing Under Slab
Meter Base Final C Si~
P.R.LF.:
Rough In
-
PHONE~ 2/ ~~I 00
IS
PHONE
FAX
CITY
STATE
ZIP
PLUMBING CONTRACTOR:
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
o Intemational Residential Code w/Indiana Amendments
o Unifonn Plumbing Code w IIndiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o POST & BEAM
o BASEMENT
WALKOUT:
y
N
Additional Fees
!!JL - ;JJJ;f
~ TOTAL, fJj1 ;;?5
'-~ '/dr /l 7{Jt~ . /~~ItJS
Fee ReceIved b "-"
Reviewed/Approved: Depl. of Community Services (Date)
S:PermIts/Fotms/ILP RESIDENTIAL