HomeMy WebLinkAbout06020095 Application
City of Carmel/Clay Township ~ Permit #(){/J;?ot115
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME
PHONE
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STAT~ ZIP
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FAX
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S'fREET ADDRESS
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CITY
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PROPERTY
OWNER:
NAME
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BEST METHOD OF CONTAcr:
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PHONE
FAX
BUILDER'S EMAJl ADDRESS
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STREET ADDRESS
CITY
STATE
ZIP
LOT #
SECTION
LOCATION
&. PROJECT
INFO:
SUBDIVISION NAME
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ADDRESS OF CONSTRUCTION
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WATER UTILITY .atJ. -:I:i' $) ~ 11 .
PROVIDER: '-lI.. ...~ ~f.o--,
<k. "3 :>-.. SQUARE , I
c:..... (l;.,....o-l I..t.J.. FOOTAGE: ) T i '1 ~ "1
ESTIMATED COST OF CONSTRUCTION: ... I
(EXCLUDING LAND VALUE) "l>. ~ .... \ I .
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SEWER UTILITY
PROVIDER: c... \.~ ~ 10
NAME OF LmUTY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); ANO/OR COUN'TY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
TYPE OF CONSTRUCTION:
8"" SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
~NEWSTRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING Wh~ Plumbi,nQ,COd W, i,lI be applied to the construction:
o DETACHED GARAGE CjJf!!l~..'1~\o'ti,'I~~i~~'(l~f~~Rl/'~~i8a Amendments
o ATTACHED GARAGE ~b)tlf"nn 1'.1w11~!!l991~~/1'I(~~!'!~it~~ 'Amen~ents
o DEMOLITION _(MUlti-f,~'t'j!bB>~lf\~qi?j1_C~~:I)(jc;: Jlalions
PROJECT INFORMATION: J1r,:'p-T
Manufactured FdUND~6N':;tyfPti r'tc1iei:":'ijIfth!!I~l!!l!Y for the new
~:~~i~:elease _Y /N Trusses: Y /N l(hh~tnuctioD,a,f.~~)H=L I CLf\'!' rC);'INSHIP'
. ....../,; ~ 0 CRAWLSPAq:jIiJDIANAI POST & BEAM
Lot Split: _ Y _N Sump Pump: . Y =N 0 SLAB ' '~BASEMENT
Does any part of the property lie within a special Flood designation area: _ Y ./'N 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 strucrure, or any change in the use of land or
strucrures requested by this application ",rill 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
use nee ied until a Certj!j9t 0 ccupancy has been issued by the Department of Community Services, Carmel, Indiana.
/ ~.,.. , Glq~ ~'~,}.Jo(.
Print Date
OFFICEUSEONLY:************************************************************************
Filing Fees: J ~{'13 9 b
INSPECTIONS REQUIRED: I '- .
~ ~ ~ ";~ Base Inspections: d. C 7. ",0
pper Footin' ower Foo~ Under Slab
_ - -. Cert. of Occupancy: 5(, S d
Ro gh In ('riiil ~ P.R.I.F.: / J. (, (,
# Charged Re-
Reviews
Fee Received y:
Additional Fees