HomeMy WebLinkAbout06030162 Application
City of Carmel/Clay Township Permit #: 'Q&D'5Df (oV.
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, 8< Two Family: New Structures, Additions, Remodels, 8< Accessory Structures
BUILDER of
RECORD:
U Jc..
PROPERTY
OWNER:
€
LOCATION
8< PROJECT
INFO:
LOT #
d).O
NAME OF UTILITY CAVA CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
TYPE OF CONSTRUCTION:
o SINGLE FAMILY _1-.
~OWN HOMEC?'lhv~r
o lWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
jErNEW STRUCTURE
o ROOM ADDmON(S)
o PORCH ADDmON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEM0LIT10N
PHONE
o ~3S::::>
CITY
0t-~530
BEST METHOD OF CONTACT:
~,c.oPYl c-rrzq;
FAX
cm
STATE
ZIP
SECTION
rd
71.) %03~
ZONING:
ESTIMATED COST OF CONSTRUCTION:
CLUDING LAND VALUE) /
SQUARE
FOOTAGE:;<5;; .::3
~
Plumber's Indiana State Liceise #:
~PICOJO )0
Which plumbing codes will be applied to the construction:
~ntematlonal Residential Code w/lndiana Amendments
o Unifonn Plumbing Code w/lndiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release ~~ Manufactured /,
Permit: Y ~! Trusses: LyJ N
/"\ 0 CRAWLSPACE 0 POST & BEAM
Lot Split: _Y _ Sump Pump: Y ~ ~ SLAB 0 BASEMENT X
Does any part ofthe property lie within a special Flood designation area: _Y ~__ WALKOlf':: ._;;.:::::y,~
For Single E~yand Two Faf!lil. .tdl'~fi..A4ditions, remodels, and/or accessory structures, this pkn;ri~ ~ ;vaIiH;phJjt&'h~t~~tihD~~l?~ilIri.qiCes
within 18NaY.s~of.tijc:=A~~~ ~f !~.~,cX,'f!h~~g:p,:~;;~d must be completed (Certificate o~ ~c~4I?ancy iSSUed) within 18 mon~~ o~ ~~e
issuance date. Class I ~t;:ru~t:Ure'pernuts'?ate'.f;\lp~.t ~J~,h~ ~!o:le,rat Administrative Rules of the State oUndiaria (See 675 lAC 12) regarding,~iration
~,.._- .,., :i, i>.,.? !iJC!iltimefr'~~foi'begilmingandcompletingconstruction.\Ir\\\ ~ j ?nnf; Ili 1)'\
I, the und '. :' Jgree._ [~\tiiai anyc.onstru~tion..J"e~d&tii:ictio. n, en!. .argement, relocation, or alteration of a strUOt1..tre. or J~A:ii'ange irt~e use oflandlor.
structure (l,hy tJtis.appUcacton ~'tolnPIY3Hili;iand." confqrm to, all applicable laws of the State of ~chah?4 and the "Zoning Ordinance ,of caime1
Indiana -1993" (Z-289) illdain";'dirients. iM~~nAer.~i.\hoQty.ol LC 36-7 et seq. General Assembly 01 the'Stat~\;>IIndiana,and..u"^ttsamen1htory
thereto. I further certify that onlY, ~tch.a.!. ~~W1, and tlJcrl. m!~~are _~1mected to the sanitary sewer. I funhh certify that the construction will not be
c: occupi~d un~ a CertiIicateofOb~fiPancy~ been C. the D:;;~.t OfCO:~ty S~;7~.Indiana.3 ~ /0 0>
Sig ture of Owner or Authorized Agent Date
OFFICEUSEONLY:******************************************************~****************
Filing Fees: ~.3 I , 3 ()
~INSPECTIONS REQUIRED:
Base Inspections: (~ 7 I SO # Charged Re-
r-- ~ 0 ReVlews
Cert. of Occupancy: ..:::> ( , 0
P,R,LF,: ! ;< <.a.-r . 00
~. TOTAL: _* .~d.- ~O
o.JlfA~' ~\ 'l
Fee Receive by: - tt ! 1-/ I 0 CtJ
Upper Footing Lower Footing
~r-B~
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Additional Fees