HomeMy WebLinkAbout06020094 Application
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(;ity of Carmel/Clay Township Permit #: ()i!O)..OO 9 'I
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
PROPERTY
OWNER:
s
LOCATION
&. PROJECT
INFO:
SEWER UTIlITY
PROVlDERC Ii . P
NAME OF UTI EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
ry( NEW STRUCTURE
o ROOM ADDmON(S)
o PORCH ADDmON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
PROJECT INFORMATION:
Early Release
Permit:
FAX
(3} 3 -"31b'
ZIp
<f(p:n~
BEST METHOD OF CONTACT:
FAX
(31
01Y
STATE
SECTION
I
ZONING:
SQUARE
FOOTAGE:
ESTIMATED COST OF CON~ON:
(EXCLUDING LAND VALUE) Hc-J -
i\\
Hll l H
L' II:
J~ Cle,
<:.-.,'.1
PLUMBING CONT CT
i ' 11'
ffl/J./ E. SM'I,f:ii Lli
Plumber's Indiana StatlfLicense #:
101777 L___
2 1 2006
!:l ii;
Ill: ill
I L./ J 1
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Whl9"'Plumbing codes will be applied to the construction:
('l( International Residential Code wfIndiana Amendments
o Unifonn Plumbing Code wfIndiana Amendments
(Multi-Family Construction Code)
I
FOUNDATION TYPE: (Check all that apply for the new
construction area)
/ Manufactured /.
_Y ~ Trusses: ~Y- N
Vv 0 CRAWLSPACE
Lot Split: _Y N Sump Pump: _Y _N 0 SLAB /
Does any part of the property lie within a special Flood designation area: _ Y ~N
o /POST & BEAM
0' BASEMENT ./
WALKOIJT:_Y~N
For Single Family and Twof~y'\d~~lli~gs,~adqjtions. remodels, and/or accessory structures, this permit is valid only if construction commences
within 180 days of the date 9fJ:"8~~Ce bf the,lMi1dIri'fie@t';an;d\!1lus~be cc;;>mpleted (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I st;;;ttt:ie'phillirS'ire~subject>to the,Genf;'iI~A{Umhi~rirtive Rules of the State of Indiana (See 675 lAC 12) regarding expiration
of f]t,c;; ~ ~ tiiDe"'frame~ fOl}6egfnning:aiidcompleting construction.
. " ,__ ,:,,'0 t.1lllj ! J"''''.~'C "'. . ,........ .
I. the underSIgned, agree tli'at.":l1Ytco,nstruc;:non, rec,~nsl;rucoonieIilaige_ment, relocation, or alteration of a structure, or any change m the use of land or
structures requested bYlthis'aI?plicatiml~lJ"~oMPiy,~ili;:'andconfonn,to"all applicable laws of the State of Indiana, and the "Zoning Ordinance of Cannel
Indiana -1993" (Z~289) and amehdtnen'tsraam...tecl'under.aiithoriry"'M fC~36~7:eeseq, General Assembly of the State of Indiana, and all Acts amendatory
. .. :-J:r.''-{ . I " J' V 1-_~
thereto. I further certify that o)1ly kitchen, barlt'.fflc[P2~rarams are conr1#@~(fthe sanitary sewer. I further certify that the construction will not be
u d or occupied until a Certificate of OccuplD1:!YMSI~ issued by the Deplltment of Community Services, Carmel, Indiana.
,. .
.B - Loll.; A. B:Il..M()~-i-6I.l;^,E ,1/I'7/0t.
Signature of Owner or Authoria: Print Date
****************************************~**~**{/*******************
Filing Fees: ,i?L'7 ::" ()
INSPECTIONS REQUIRED: ---; 7- ~o Ch d R
Base Inspections: ....L- (, _, .J ' # arge e--
,c / <:;:"J\ ReVIews
Cert. of Occupancy: 2./-:- U u
P.R.I.F.: ,;z (, . (I Additional Fees
/ f ..6 5"., tf ()
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