HomeMy WebLinkAbout06020049-Application
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City of Carmel/Clay Township \0' &- ~ I permit#OhO:J()()ifCj
RESIDENTIAL IMPROVEMENT LOC.ATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of NAME'
RECORD:
BUILDER'S EMAIL ADORES
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PHONE FAX
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STATE ZIP
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BEST METHOD OF CONTACf:
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PHONE FAX
PROPERTY
OWNER:
NAME
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CITY
STATE
ZIP
STREET ADDRESS
LOCATION
&. PROJECT
INFO:
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SUBDMSION NAME
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SECTION
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SQUARE
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SEWER UTILITY WATER UTILITY
PROVIDER: C-L _.: \ PROVIDER: ~DLb
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TYPE OF CONSTRUCTION: ~~\.0 . . EO MPR V MENT:
t> SINGL~.'~~Cy / 0, c" /A!:lI EW STRUcrURE
o TqWf'lI;iOME ~ . I2J ROOM ADDmON(S)
o TWO.F:~ ~~ //0 PORCH ADDmON(S)
# of,4" . 0 REMODEL
o MUL TI;~A V' 0 ACCESSORY BUILDING Which plumbing codes will be applied to the construction:
o R~~6~~L (FoV ' 0 DETACHED GARAGE ~ International Residential Code w/Indiana Amendments
~ r 0 AJ;f,bPiED GARAGE . . .
Additions, R~els, Etc.) 0 ~h" 0 UnIform PlumbIng Codew/Indlana Amendments
S b "Id FOP. r'ONS~tl-Famlly Construction Code)
PROJECT INFORMATION: U ~ect t6 t(Jf/'jPIi{j~C" . .UC Ifr'
Early Relea ManufactKred 6f Iiltate "11'" II WiiC!l PE: (Check all that apply for tlhe new
. se "" . UcPT 0 0ik>"A.u 1.0Ca:l<0 on a
Permit: _Y ---L-N Trusselji. J2E'-'-YWIMUNI . E
Lot Split: _Y .,. N Sump ~ltY: O~ / C~E
Does any part of the property lie within a special Flood lteSig,n,~~i1ln area: ~"'fI:t' N
EsnMATED COST OF CONSTRl!Q10N:
(EXCLUDING LAND VALUE) crI. b 7:5:.
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UMBIN CONTRACTOR:-
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Plumber's Indiana State License #:
o POST & BEAM
~BASEMENT
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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 r uested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana -199 (Z-289) and am dments, adopted under authOrity of l.c. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I fur er c that onl kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
used or occu ied ntll a Cert' ate of Occupancy has been issued by the Depanment ommunity Services, Carmel, Indiana,
Print
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P.R.I.F.:
Additional Fees
Reviewed/Approved: Dept. of Community Services (Date)
S:PermIts/FormS/IlP RESIDENTIAl