HomeMy WebLinkAbout06030039 Application
City of Carmel/Clay Township c:,lll Permit itO(; (j 3 ()() ?/1
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
NAME
PROPERTY
OWNER:
NAME
STREET ADDRESS
LOCATION
& PROJECT
INFO:
LOT # qq
ADDRESS OF CONSTRUCTION
SEWER UTILITY
PROVIDER:
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DO
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
TYPE OF CONSTRUCTION:
1;;,r....SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
~EWSTRUCTURE
o ROOM ADDmON(S)
o PORCH ADDmON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
FAX
20I-
L/t/o
PHONE
CITY
STATE
ZIP
ZONING: 5
/
PROJECT INFORMATION:
Early Release /" Manufactured FOUNDATION TYPE: (Check an that apply for the new
I../' r./' N construction area)
permit~ _Y _N Trusses: -y ~RAWLSPACE 0 POST & BEAM
Lot Split: _Y ~ Sump Pump: ~ N .Q-sLAB G-BlISEMENT
Does any part of the property lie within a special Flood designation area: _ Y ~ WALKOlJT:_ Y ~
Fo~ Single Family and Tm~l\,e,~~~~i~II$~~lil<!<!<lUliidfdG:'obsory strucrur.,.: this permit is valid only if construction commences
. Wlthin 180 days of the da'o/1;!'l~~an~c;....~[_~~~J.'~U~t!.lttg~. ~~l)f{tRs~~pleted (Cenihcate of Occupancy Issued) WIthin 18 m?nths of th~
Issuance date. Class I st~ periW.ts'.lttet$U'bj~t ffi t'fielt?ep~!4l~EDUmstrauve Rules of the State of Indiana (See 675 lAC 12) regardmg expiratIon
ot Stolte tiJitSf~f~~n~ ~n~~mpleting construction.
I, the undersigned, agree ~'lfOqs~qjT~PvG' ~- cfil1~tion, or alteration of a structure, or any change in the use of land or
structures requested by thi lidtio'li' ~rnplii wi ~c1 F.q ~\l~e laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana -1993" (Z-289) <GI ~GilIb]IMtlll.d ~ 011:e~~1M~~4: General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen, bath, tMIt\IAN~s are connected to the sanitary sewer. I further certify that the construction will not be
used or occu. until a Cert. cate of OccupancylUiS been issued by th epanment of Community Services, Carmel, Indiana.
({ () lC }-l-U6
Sig
Date
OFFICEUSEONLY:*******************************************************~****************
Filing Fees: ~ '?So 'i? U
~N~PECTIONS REQUIRED: ...., ,. 7, ,r-,...... # Charged Re-
- - ~ Base Inspections: ,6,jg ,,;;Ll.../
{lpper Footin~er Footing det,Slab k" /. e.-V Reviews
- - Cert. of Occupancy: <J '.-1 _
eU9h 19 ~ter B~ Final Site ' , 0 0
P.R.I.F.:
I
C_\r'D.. > U.l~ 3-31::56
RevieWed/App;;;\et-~epl. of Community Services (Dale)
S:PermIts!FormS/IlP RESIDEmAl Fee R