HomeMy WebLinkAbout06040005 Application
City of Carmel/Clay Township Jt;tpo Permit # {)boLj--OOO 5
RESIDENTIAL IMPROVEMENT LOCAtIbN PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
NAME I I
/'- Ii-.n-.Yc.-Wor1cs~
PHONE
:,.,)~1 ~ - OLl-ll z..
FAX
(~.,) S"1')-,\Z!1 S'
STREET ADDRESS
4'2...1 'S.
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CITY
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STATE
IN
ZIP
'+I".O"S'Z...
BUILDER'S EMAIL ADDRESS
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BEST METHOD OF CONTACT:
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PROPERTY
OWNER:
NAME
Do-.
BLl cJ-.e....
12.1 c1'.) c. c..-h
SUBDIVISION NAME D .
s "',,, 1vt.:1I '<UC,.
Sp,.in 12.iJ.<;c.. Go Ce..".....e.!
WATER UTILITY .,m
PROVIDER: .F17A Tnd
PHONE
('31/) ~t.,"-'+~"'f
FAX
STREET ADDRESS
~4'f S.
CITY
L6.N" "" <.J
STATE
IN
ZIP
41..
1-
LOCATION
& PROJECT
INFO:
LOT #
IS'
SECTION
ZONING:
52..
SEWER UTILITY ...........\
PROVIDER: '';:P- t-J / It
IN
y (..Q3 2-
SQUARE
FOOTAGE:
11..&
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) +2..0 I 0 c) D
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / 8PW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'$ (IF APPLICABLE):
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
~ RESIDENTIAL (For
Additions, Remodels, Etc.)
\ It'/.. \7-
~
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o .-ROOM ADDITION(S)
C>?' PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
"1\\
q I 'L ~
Ii 'Iii
'i If
If: J LUUO i i1V I
Which plumbing codes ill be applied to the construction: I
.J
o International Resl en lal CoOe w/lndlana Amendments
o Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
N/~
PROJECT INFORMATION:
Early Release Manufactured FOUNDATION TYPE: (Check all that apply for the new
./ ./ construction area)
Permit: _Y ~N Trusses: _Y ~N
Lot Split: _ Y v'N Sump Pump: _ Y...-N 6 ~:'::LSPACE
Does any part of the property lie within a special Flood designation area: _Y /N
~OST & BEAM
o BASEMENT
WALKOUT:_Y /N
For Single Family and Two Family dwellings. additions, remodels, and/or accessory structures, this permit is valid only if construction commences
within 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits arc subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
time frames for beginning and completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or
structures requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the ~Zoning Ordinance of Carmel
Indiana - 199r (Z~ 289) and amendments, adopted under authority of l.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
used or occupied until a Certificate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
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Signature of Owner or Authorized Agent Print Date '
# Charged Re-
ReViews
Additional Fees
Reviewedf A
S:PermttsjFormsj
(Date)