HomeMy WebLinkAbout06030097 Application
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CityofCarme//Clay Township \.u ~v'V\ permit#:fJIt2 6 3~t) CJ7
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUIlDERtS EMAIL ADDRESS
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BUILDER of
RECORD:
NAME
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STREET ADDRESS
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PROPERTY
OWNER:
STREET ADDRESS
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LOCATION
& PROJECT
INFO:
LQT #
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SUBDIVISION NAMG
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SEWER UTILITY
PROVIDER:
ADDRESS OF CQti2TRUcnON
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FAX
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CITY
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ZIP
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BEST METHOD Of CONTACT:
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CITY
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STATE ZIP
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ZONING: \
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ESTIMATED COST 0" ~'pr1SiRurnClN:~ D \ . \1
(EXCLUDING LAND VA\WE)' ,
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SECTION
NAME OF UTlUTY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
LJ
TYPE OF IMPROVEMENT:
&if NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITlON(S)
o REMODEL
o ACCESSORY BUILDING Which plumbing codes will be applied to the construction:
o DETACHED GARAGE va"International Residential Code wI Indiana Amendments
o AlTACHED GAR.iGE 0 Uniform Plumbing Code wI Indiana Amendments
o DEMOLITION _,,~ (Multi-Family Construclion Code)
PROJECT INFORMATION: .,~& ~
Early Release ~ M f ct d~ !fQQ/..l~~,..FOUNDATIONTYPE: (Check all that apply for the new
T anu a ure 7..l!SA ",}} "'", (,T-iruction area)
Permit: _Y ~y- russes' ~~(".. "VA
./ N . : o. ~ ""'fi ~WLSPACE 0
Lot Split: _Y _N Sump Pump: -(!j, ~~~q..,O' 91.~n /0;;( ./
Does any part of the property lie wit~in a special Flodd a ~i,'" -./ N Y V N
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
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PLUMBING CO NT CTOR:
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Plumber's Indiana State License #:
'?3\ olPY sLfO
POST & BEAM
BASEMENT
WALKOUT:
For Single Family and Two Family dweJ1t.itg<add.'~th;ms, remodels, and~;:J-"jBo ~~g.,<2.r.. . is valid only if construction commences
within 180 days of the date of issu~ce o~5!i!.': 1?~iI~ing permit, and mu~.t~e1'9 t a <(\ ~at ~~ ncy issued) within 18 months of the
issuance date. Class I structure permi.ts.are'subje5~fi"[,he General Administr*~$ ate of I~na (See 675 lAC 12) regarding expiration
".': - ~A1~Jrames for beginning and coITrj'l\eting tr' n.
J, the undersigned, agree that any constructioprtic"qnst'ruction, enlargement, relocation, or altera ctJ.lre, or any change in the use of land or
structures requested by this application will ~m'p!y',\Vith, and conform to, all applicable laws of the n~iana, and the "Zoning Ordinance of Carmel
Indiana -199r (Z~ 289) and amendments, adopted'lInder authority of LC. 36~7 et seq, General Assembly ~ State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen, bath;>and floor drains are connected to the sanitary sewer. J further certify that the construction will not be
r occ ied unti CertIfi t f Occupancy has been Issued by the Department of Commumty ServIces, Carmel, Indiana
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Prmt ~ ~ Date
Under Slab
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# Charged Re-
Reviews
Site
Cert. of Occupancy:
P.R.I.F.:
Additional Fees
Reviewed/Approved: Dept. of Community Services (Date)
S:PermitsjFormsjILP RESIDENTIAL