HomeMy WebLinkAbout06030114 Application
City of Carmel/Clay Township O~ermit tlJWJ3()/J f
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of NAME
RECORD:
PHONE
CITY
STATE
~
BUILDER'S EMAlL ADDRESS
BEST METHOD OF CONTACT:
PROPERTY
OWNER:
NAME .s-
PHONE
FAX
STREET ADDRESS
CITY
STATE
ZIP
,"- ~ _.._-.~._.__.__.._~~..~ ~
LOCATION
& PROJECT
INFO:
LOT /t9?>
ADDRESS OF CONSTRU
SEWER UTILITY C i
PROVIDER: t-
WATER UTILITY
PROVIDER:
fiLS
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):
TYPE OF IMPROVEMENT:
M NEW STRUCTURE
7cY ROOM ADDmON(S)
o PORCH ADDmON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE.....J
o ATTACHED GARAGE-W
o DEMOunON
Jh /COt- . -X~A-P.
PLUMBING CONTRACTOR: .
IflJtJ/56K :;Z;:;~E~ 7Ya.der9
Plumber's Indiana State License #: \
c-17~ f)<fX)4- ' - ~;
Wh;" plumbing codes will be applied to the construction:
[J'International Residential Code wI Indiana Amendments
o Unifonn Plumbing Code w IIndiana Amendments
(Multi-Family Construction Code)
TYPE OF CONSTRUCTION:
1'16 SINGLE FAMILY
fi TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release --K. . Manufactured FOUNDATION TYPE: (Check all that apply for the new
y construction area)
Permit: _Y N Trusses: _Y-4-N
" 0 CRAWLSPACE
Lot Split: _Y LN Sump Pump: ~Y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _ Y -A-N
o POST & BEAM
~ BASEMENT
WAlJ(OUT:_Y~N
For Single Family and !w~!amil,>; dwrl)..OORS,~t9-P~~s, and/or accessory structures, this permit is valid only if construction commences
within 18q:<f~~'Y~.~lt;1ofi~h&;M;1:rre:M.if(Hn'~rm.,tt, and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. I crass I st;ruc;~wfrirPje.tt @'ii1tlfe~dministrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
SUDjeCllO [; , , fe8fre'1leSforbeginningandCOrnPleti~lilQ~II.A II
I,theundersigned,agreE>th;ii~\r'C&b~~~)o~~q~ement,relocation,or . n. .h ~Jt.Li~~~~oflandor
structuresrequl~!I@@M~PlY~l.ii?:a.~~ijV.tQ'allapPliCablelaw h a 0 , . . 0 "'8rdhianceofCarmel
Indiana - 1993'"-' ~ 8 , 1. tyJ.~lL 36~ 7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I uGh e. tH mm f~d floor drains are connected to the sanitary sewer. I further certify that the construction will not be
used occupied un . a Ci . 'ca~E:y has been issued by the Department of Community Services, Carmel, Indiana. .
. . 0L-'yAlAJ ~(q/~U)C;c; -:(tt/Oh
Pnnt Date
OFFICEUSEONLV:*******. *************f***********************~***************************
/J-.. Filing Fees: / i2/ 0 ,;z 0
INSPECTIONS !!.EQUI D: J i . I - - - /
~ ~ CJ Base Inspections: :;,.J 0 # Charged Re-
~pper F~~. r Fo~g/Under Slab ,____-:-:--.. (; // )0 Reviews
. . ;-- Cert, f Occupancy: . ")
~~eter ~ ("Final Site . _ .r/ \ , i G(. 00
\;YO~I " .
;g;tTAL. ~' ~ ":
FeeReclvp~~?/tl/)- ~ e
Additional Fees
;3-/7-
(Date)
o