HomeMy WebLinkAbout06030030 Application
WIll.
City ofCarmell Clay Township Permit #[b050(} 30
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory structures
BUILDER of NAME
RECORD: f:~'
STREET ADDRESS
,
I
BUILDER'S EMAlL ADDRESS
..
PROPERTY
OWNER:
NAME
E
STREET ADDRESS
?<c,
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LOCATION
&. PROJECT
INFO:
LOT #
SUBDIVISION NAME
ADDRESS OF CONSTRUOlON
SEWER UTIUTY
PROVIDER:
^,
-.
WATER UTIUTY --L /t (/ JJ 5
PROVIDER: c>./' \/( ,
01 '# dt.
NAME OF UTIUTY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); ANO/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPllCABLE):
,.t:v-;
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:
~ NEW STRUCTURE
o ROOM ADDmON(S)
o PORCH ADDmON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
PHONE FAX
i!>\
CI1Y STATE ZIP
BEST METHOD OF CONTACT:
-\
PHONE FAX
CI1Y
STATE
ZIP
SECTION
40
ZONING
Co\
SQUARE
FOOTAGE:
'Jo~'/l
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND ~I\LUEL - ~ -:i17;~t2>': ., :
l(r' lr:::.J ~\. r; !::.:-'_~ II \'if lE":::, j \~:
I! I ) ,2-"':::_'=~-'~---11 \ Ii
'" I II'
PLUMBING CONT I ! \ I R~IAR - 6 2006 I! I il
I M ~II
..,... I
Plumber's Indiana State !ieense-#: I
\mm~~m I J
Which plumbing codes will be applied to the construction:
..18l International Residential Code w/Indiana Amendments
o Unifonn Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
A~ Early Release / Manufactured FOUNDATION TYPE: (Check all that apply for the neQw
~ Permit: ~Y _N Trusses: /Y _N construction area) OLL. L
Lot Split. _Y LN Sump Pump: LY _N RELE;a.,~~~~N~CD'.U6ffi\'llII~M L '
. SIJbje9 tatmnpl131'ce ,vl~h .$re~ASEMIIm"
Does any part of the property lie within a special Flood designation a~'3t~Yl~1Ya1 CorJesWALKOUT:_ Y N
For Single Family and Two Family dwellings, additions, remodels, and/or acO$S~s6:lf'nf'reQM;~bilrilt is aliU'oh r fft<;nis-cruCtion commences
within 180 days of the date of issuance of the building permit, and must ~\e\lfd (~}lfIf~f~~Iicj"i~)~iliikA8 months of the
issuance date. Class I structure pennits are subject to the General AdminisM\1v~-R'irtes Of die SWc;.af,IIJ.l~a (See 675 lAC 12) regarding expiration
time frames for beginning and completing construbt'tHt.'.1 t\
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 Cannel
Indiana - 1993" (Z' 289) and amendments, adopted under authority of LC. 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 cupied u . a Certificate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
Ad",.....
Print
(l-rl ~ ,.
2-~1-ll>1c:>
Date
OFFICE USE ONLY: ***********************************************,
Filing Fees:
Base Inspections:
Cert. of Occupancy:
# Charged Re-
Reviews
INSPECTIONS REQUIRED:
(j******************
J 6 J. (0
5/ .;l)
P.R,I.F.: J. fal 00
b' ~OTA~~o! bbl. ~O
a~&)~ _A
Fee Retefved by: - - '"
Under Slab
Additional Fees
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