HomeMy WebLinkAbout05120146-Application
City of Carmel/Clay Township Permit #: 05"/J.() 14}o
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, 8< Two Family: New Structures, Additions, Remodels, 8< Accessory Structures
BUILDER of NAME \).e-\c
RECORD:
BUILDER'S EMAlL ADDRESS
PROPERTY
OWNER:
NA
SIREET ADDRESS
6
SUBDMSION NAME
LOCATION
8< PROJECT
INFO:
LOT #
ADDRESS OF CONSTRucrrON s.r "__ _ L
"100 IN. /31 '5T1 u-:l
SEWER UTIUTY
PROVIDER: N A
WATER UTIUTY
PROVIDER: N 1\
PHONE
5
FAX
q
cm
~
STATE
(
BEST METHOD OF CONTACT:
. q Itj-7Z-75
,
ZIP
-~
em
STATE
ZIP
SEmON
ESTIMATED COST OF CONSTRumON:
(EXCLUDING LAND VALU ()
NAME OF UTIUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE):
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
~: RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit:
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDmON(S)
o PORCH ADDmON(S)
10 REMODEL
\ ~ ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
Manufactured
Trusses:
PLUMBING CONTRACT
Which plumbing codes will be applied to the
o International Residential Code w fIndian end
o Unifonn Plumbing Code wfIndiana Amendmen
(MUlti-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
iY_N
o CRAWLSPACE
Lot Split: _Y -.lLN Sump Pump: _Y --JLN ~ SLAB
Does any part of the property lie within a special Flood designation area: _ Y -X-N
_Y LN
o POST & BEAM
o BASEMENT
WALKOUT:_Y~N
For Single Family and Two Family dwellings. additions, remodels, and/or accessory structures, this permit is valid only if construction commences
within ISO 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 unders ed, ee t any cons cOon, reconstrucoon, enlargement, relocaooD, or alteratIOn of a structure, or any change in the use of land or
structures req ested b s apPlicaoo~ comply with, and conform to, all applicable laws of the State of Indiana, and the "Zonmg Ordinance of Carmel
Indiana - 1993 (Z~ 2 d amendments, dopted under authonty of LC. 36,7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I fu c hat only kitchen bath, and floor drains are conn c to the sanitary sewer. I funher certify that the construction will not be
used or occup ntil Certificate of ccupancy has been issued by e D partment of Community Services, Cannel, Indiana.
W ~
Signature of Own t Print Date
************************************
c-. Filing Fees:
INSPECTIONS REQUIRED: \ \,0;
, tlase Inspections:
Under Slab
Cert, of Occupancy:
# Charged Re-
Reviews
Site
P.R.I.F.:
(Date)
***************
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Additional Fees
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