HomeMy WebLinkAbout06020025-Application
City of Carmel/Clay Township Permit #: OI.eO'J.{)D)6"
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME
STREET ADDRESt) Od-
BUILDER'S EMAIL ADDRESS
PROPERTY
OWNER:
NAME
PHONE
FAX
SEWER UTILITY
PROVIDER:
Q. \(GW
WATER UTILITY
PROVIDER:
STATE
ZIP
STREET ADDRESS
LOCATION
&. PROJECT
INFO:
LOT # 5(0
ADDRESS OF CONSTRUCTION
SUBDIVISION NAME
NAME OF lITlLTTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); ANDIOR CDUNlY WELL ANDIOR SEPTIC PERMIT #'S (IF APPLICABLE):
TYPE OF CONSTRUCTION:
.ff$INGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
k-NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
PROJECT INFORMATION:
,/ i FOUNDATION TYPE:
Early.Release "Manufactured construction area)
Permit: Y N Trusses: Y N
- r;:;-- V 0 CRAWLSPACE 0
Lot Split: _Y +N Sump Pump: _Y -f"-N '~LAB . 0
Does any part of the property lie within a special Flood designatiof( a";'a: _ Y N
PLUMB
Which plumbing codes will be applied to the construction:
~temational Residential Code wI Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
(Check all that apply for the new
POST & BEAM
BASEMENT
WALKOUT:_ Y
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 \\ill 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 r.c. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that 001 ' kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction wil not e
used or DC led until a CertIli' e of Occupancy has been Issued by the Department of CommunIty ServICes, Carmel, Indiana
. I'D \1 \(L (~YTY: f
Prmt ~ Date
OFFICE USE ONLY: ***************** *** * *********** ******** **** 6~*********************
Filing Fees: b 0
INSPECTIONS REQUIRED: EI',~~ fri$~&6iWSTRUC~~ r; 7- 5'0
nder SlaiJu ' cl to cornp:;ancs with all mgula Ions .-/1 -0
oQlt1),t9~f)t-lCL~[lCY,Ode~ S. J
Si~~TY OF~fMA~~:;~~ ~~~~CSE~p7 ~ / ()~, ~/ Additional Fees
(NO ATOTAL: P< .
,t:e'~- r:
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