HomeMy WebLinkAbout06030142 Application
~";ty of Carmell Clay Township cJ#\ Permit #Ob 03t'J / zJ-.;L
.dESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, 8r. Two Family: New Structures, Additions, Remodels, 8r. Accessory Structures
NAME
.LDER of
..:CORD:
PROPERTY
OWNER:
NAME
STREET ADDRESS
LOCATION
8r. PROJECT
INFO:
LOT #
SEWER UTILITY /'"'T
PROVIDER: ~ If< ()/ 0
PHONE
JV(-21(2- FAX ?Y{-Y2.2-i(
.....{ Ie
STATE
ZIP
<(6L l/J
PHONE
FAX
CITY
STATE
ZIP
~.6
t"'(A"l~
.5)
Y2j
ZONING:
SEmON
3
tJ'e\.
SQUARE
FOOTAGE:
WATER UTILITY /'
PROVIDER: LOJ( "" <:
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
PROJECT INFORMATION:
FOUNDATION TYPE: (Check all that apply for the new
Early Release . /' Manufactured . /'
...,.-:. i../ v construction area)
Permit: _Y _N Trusses: =-V_N
. ..-<: ......-<, dt--CRAWLSPACE 0 POST & BEAM
Lot Split: _Y _N Sump Pump: _Y _N ~LAB o-BASEMENT
Does any part of the property lie within a special Flood designation area: _Y ~.. WALKOUT:_ y<----1f
For Single FThfuy-and TWO~ . 1 . ~ if?~JJQ~JJ., and/or accessory structures, this permit is valid only if construction commences
within 180~aystoftlie\late!O~RUml1U2 oIffie lmn~l:a'P.~~ must be completed (Certificate of Occupancy issued) within 18 months of the
ISsuance date. Class I s!J:U~%<!:"eEffll5si:~pjebffime General Admmistrative Rules of the State of Indiana (See 675 lAC 12) regardmg expiration
~C::P~C r()M~ ~fi~esf5l!:!?sllinningandcompletingconstruction.
I, the undersi Nl', a eeihat'ri1)"tons~~hhoc~Ht.aittatiement, relocatIon, or alteratlon of a structure, or any change m the use of land or
Strucrures s e ~ ;4lPIIM€4..~N.SfIImlX>, all applicable laws of the State of Indiana, and the "Zorung Ordinance of Cannel
Indiana - 1993" (Z- 289) and amendmR" ^c\Pp~d ~nder ~Jt1onty .oree. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto I further certify that only lUt~1ra~~lIit,\and floor drams are connected to the sanitary sewer I ft.\rther certify that the construction will not be
used or occupied until a Certificate of Occupancy has been issued by the Depanment of Community Services, Carmel, Indiana.
7- ;p L {:'j( rJ Ce: -; ~2... "L. -ro6
ture of Owner or Authori Prjht 6ate
OFFICE USE ONLY: *** ** ****** **** ** *** * *** **************** * *** *@:****;i*******************
Filing Fees: J() I L. '()
INSPECTIONS REQUIRED: , I
Base Inspections: _:? (, '1 J & # Charged Re-
./ ReViews
Cert, of Occupancy: 5' ~ ') ()
U G I. 00
I 7
~
TYPE OF CONSTRUcnON:
s--sINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
~ STRUCTURE
o ROOM ADDmON(S)
o PORCH ADDmON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Plum
Lower Footing, Under Slab
9
P.R,LF,:
Additional Fees
Reviewed/Approved: ept. of Community Services
s:PetmIts/Fonns/ILP RESIDENTIAl
FleE! Received (v:
3(),~
( ./~OTAL:.