HomeMy WebLinkAbout06030041 Application
I
City of Carmel! Clay Township \j 1 ~ Permit #6~l/:;OO1-l
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
'.
BUILDER of
RECORD:
FAX
6/0-
ZIP
/
PROPERTY
OWNER:
FAX
cm
STATE
ZIP
LOCATION
&. PROJECT
INFO:
SEWER UTI
PROVIDER:
NAME OF UTIllTY EX VAT! NTRACTOR; PLAN COMMISSION / BZA / BPW OOCKEr
NUMBERS; TAC DATE(S); AND/OR COUNlY WElL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
TYPE OF CONSTRUCTION:
~INGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT: PLUMBING CONT .
a-NEW STRUCTURE Lfq WI rYI IT S /11 S -.t;, ~
o ROOM ADDmON(S) Plumber's Indiana State License #:
o PORCH ADDl!lO!:l(S) C- f I 0 cy)o / ij I
o REMODELREI"~t';..
o ACCESSOS(jll 'rt~lSD ~:~~~~b~9 codes will be applied to the consttuction:
o DETACHED G EfS liOn;',. .. "~Btem~d.s~"lijll Code wflndiana Amendments
o ATTAC~l~ ~ ~llllt:l WIth all~ v/V
o DEMOl5tf" Ofi (: &OO~. ,-pJ ~wflndianaAmendments
. . Olf OfvliVIU~lI '. iii nstruction ~ode)
PROJECT INFORMATION: . CAFlM2Foi ~1LI~"'_ '
E I R I M . ct red ~ ,.~ 1"fIlIIRj (Check all that apply for the new
ar y e ease ~ anu.a u. IN'"'" ction NSH ~ (
Permit: _Y N) Trusses: N """~f,I\ IP vi
o CRAWLSPACE 0 POST & BEA .;1'iiSfJed
Lot Split: _Y N Sump Pump: Y N 0 SLAB /\ 0 BASEMENT/.{) 'J3::tftK.
Does any part of the property lie within a special Flood designation area: _ Y --L.l;!) WALKOUT:_ Y ~
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 requested by this apphcation will comply with, and conform to, all apphcable 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. 1 further certify that the construction will not be
or occupied until a Certificate of Occupancy has been issra- the Department of Community Services, Carmel, Indiana.
..- "- U/,~ /c:> ( (j ~
. S. nature of Owner or Authorized Agent p' t Date
OFFICE USE ONLY: ******** ******* ********* ***** ******* ** * * *** * ***Jl**;!:i"****** *************
Filing Fees: y.), 9(1
PECTIO UIRED: I <J (/:
. Base Inspections: r,L (; 7, s (J # Charged Re-
Upper Footi Under Slab ~ ReViews
Cert. of Occupancy: ..J I ;) ()
~~r~ ,~ PR'F /cJ(;! ~
Reviewed/Approved: Dep!. of Community Services (Date)
S:Permlts/FoI1TlS/ILP RESIDENTIAL
Addibonai Fees