HomeMy WebLinkAbout06010136-Application
City of Carmell Clay Township C tU- Permit #()hrJ! ()! 3b
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
FAX
575.",(3W ><.":<3'6 575-,;;}.31
STAlE
Ca ( Jrl€ / -;.;
CITY
S30
ZIP
BUILDER of
RECORD:
PHONE
BEST MErnOD OF CONTACT:
VI
PROPERTY
OWNER:
PHONE
FAX
CITY
STAlE
ZIP
LOCATION
& PROJECT
INFO:
-
SE ON
ZONING:
5-1
...e
SQUARE
FOOTAGE: :5W
00
3~
PLf!CBING CONTRACTOR:
VYI YJ.? d- ~VJ~ ..LYlC-
Plumber's Indiana State License #:
C-PIOOOOI D /
o
o
OJECT IN
ATI
Which plumbing codes will be applied to the consb-uction:
~matiOnal Residential Code w/lndiana Amendments
o Uniform Plumbing Code w/lndiana Amendments
(Multi-Family Construction Code)
G> Manufactured ~ FOUNDATION TYPE: (Check all that apply for the new
construction area) ~Pj),
Y Trusses: N U- VI . /.
- _ '\ 0 CRAWLSPACE 0 POST & BEAM/A 1 YlIJ/Ie.O
Lot Split: _Y ----e/ Sump Pump: N 0 SLAB ~EMENT I&s~L
Does any part ofthe property lie within a special Flood designation area: _Y ----Lfl WALKOUT:_Y~ .
For Single Family and Two Family dwe~~J.!@g.~~fDn;J~rf~ ~P'ry~ffil.fwrH'h this permit is valid only if construction commences
within 180 days of the date of issuance~ t,h.f.;:~~&:e'~(WJdlJIrtiii:1.1it a~'{CbWilfcate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits are.wb~ect ~gtt~~~~~e~d.~~~rr~es of the Stat~ of Indiana (See 675 lAC 12) regarding expiration
. . .. ~~":",esAOj~~ij1giPl'\.~",!,PlqgIJA~@1ct1on. .
I, the undersIgned, agree that any construc~~qns@..tftiCj),\~~, \-aJca~,"~Qr ~~~a structure, or any change ill the use of land or
structures requested by this application will I"l"ij'I~b;oW~rf, ~Yabf~t;lIiR~!l:te of Indiana, and the "Zoning Ordinance of Cannel
Indiana -1993" (Z-289) and amendments, ~tl~tect Un'iIer kdm n A~i N: seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen, bath, and floor drains lNelftb the sanitary sewer. I further certify that the construction will not be
u occupied until a Certificate of Occ~pancy has been issged b the Depanment of Community Services, Cannel" Indiana.
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Sign ture of Owner or Authorized Agent Pri Date
Early Release
Permit:
OFFICEUSEONLY:************************************************~~~*********************
Filing Fees: <;7..1 -5.. '30
NSPECTIONS REQUIRED: . 7?, 7. .)i1 # Charged Re-
ab Base Inspections: ::::- - ~ Reviews
'\ Cert. of Occupancy: (I .:>:0
Site)
~ P.R.I.F,:
~~
(Date)
Additional Fees
30
Fee Received by:
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