HomeMy WebLinkAbout06030110 Application
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City of Carmel/Clay Township Permit #()hl/9()/It)
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
PROJECT INFORMATION:
Early Release ^ Manufactured A
Permit: Y -LJj/ Trusses: ~ N
- /0\ - /:J.. - 0 CRAWLSPACE 0 POST & BEAM
Lot Split: _Y -LtV Sump Pump: -0J_N 0 SLAB R BASEMENT ~
Does any p~,?,f ~h,!!,I!~?pe~ lie within a special Flood designation area: _Y ~ WAlKOUT:_
For Single ~Y(M~i-;;;--f:millY we. . irtfa!JUe~ and/or accessory structures, thispennit is valid only if construction commences
within 180 days of th~9..it~'9f~a1RE'ofdlh Qy.a~~fnand must be completed (Cenificate of Occupancy issued) within 18 months of the
issuance datb. Class I sffue1Jntpe~ l~et\9jebW 'tli~ "GeneYJil~dministrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
EPT OF COMMIIII.I pJIle tt..ilties for beginning and completing construction,
I. the und~. ~ FhaA ~ 'iO,llSUUCti~thoc~;;ement, relocation. or alteration of a structure, or any change in the use of land or
structures requestedoy this"~f>Atw:mlv.A1.r'aJmDl'y~~4 PW'\-I;.o, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993" (2-289) and amen~:"'~1ied undeHtY&i rotlItC. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only idt~li'd(1:l~ and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
u 0 occupied until a Certificate of Occupancy has been iss y the Department of Community Services, Carmel, Indiana. , /
e--e Sf-ev 01/ ,oe. c~) /4/0 (b
Date .
BUILDER of
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER
PROVIDE
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
PE OF ON UCTION:
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
..a-NEW STRUCTURE
'i3 ROOM ADDmON(S)
o PORCH ADDmON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GAR'
o DEMOLITION
Si ature of Owner or Authorized Agent
int
FAX
57&--d31
ZIP
{).3 c9
PHONE
FAX
C1lY
STATE
ZIP
ZONING:
sl
Which plumbing codes will be applied to the construction:
~temational Residential Code wI Indiana Amendments
o Unifonn Plumbing Code w/lndiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the
construction area)
OFFICEUSEONLY:*********************************************~~************************
Filing Fees: ?l.6 Y. .L. (')
INSPECTIONS REQUI. RED: 2' . 6' 7, /10 # Charged Re-
~ Base Inspections: ~' ~ ,
~~ ower Footing Under~lab - S ISO Reviews
~ ~ Cert. of Occupancy:
~ ~~_~ P.R.I.F.: / 2 6/ DO Additional Fees
Reviewed/Appr ved: Dept. of Community Services
S:PermltstFormS/ILP RESIDENTIAL