HomeMy WebLinkAbout06010154-Application
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City of Carmel/Clay Township 0\.- Permit iiOI:-/)l Ofl
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME ~
STREET ADDRESS
<&'3
BUILDER'S EMAIL ADDRESS
Cleo q(, .
PROPERTY
OWNER:
n
STREET ADDRESS g 3 4-
LOCATION
&. PROJECT
INFO:
LOT #
SEWER UTILITY. .
PROVIDER: Cay me-I
WATER UTILITY .
PROVIDER: C a.. y m el
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I 8PW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units: . ~
o MULTI-FAMILY \~iy
/ # of Units: \/
~ RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
[if' ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
FAX
ZIP
41003;)..
CITY
Caymd
BEST METHOD OF CONTACf:
PHONE
ZIP 4fo03~
SECTION
ZONING: 1::>
r-..\
~
SQUARE
FOOTAGE: I g- D
.1.5 D l)
ESTIMATED COST OF CONSTRUcnON:$
(EXCLUDING LAND VALUE)
iV-A
PLUMBING CONTRACTOR:
N-A
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
o International Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release / Manufactured FOUNDATION TYPE:
Permit: _Y ~ Trusses: Y VN construction .re.)
/ B4iAWLSPACE
Lot Split: _ Y _N Sump Pump: Y ~N 0 SLAB
Does any part of the property lie within a special Flood designation area: _Y VN
(Check .11 th.t .pply for the new
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 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. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
used or occupied until a Certificate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
fP.,~iIr^.Jt,V Jon/) Go/.( Id .,}-,;)-Ol>
Signature f Owner or AuthOrized Agent Print Date
OFFICE USE ONLY: *******************************************************~**************
Filing Fees: fl 0 I ~ 2
INSPECTIONS REQUIRED: . 53 50
Base Inspections: .
Upper Footing Lower Footing Under Slab 0::.=1 Ii:TION &:, 50
R~ED FOlit.OON:""!ldI'lCy.. ..:..> I
Final S~ comrjJian;;e ~Iith ;11;egulatlons
of State a'i~~cCC.! ,-,oues.
DEPT OF COMM' ii'IITY ~ ~
ARM . . C YIP
Rough In
Meter Base
# Charged Re-
Reviews
Additional Fees
Review 'd/A proved: Dept. of Community Services (Date)
S:Pefmi Form ILP RESIDENTIAL