HomeMy WebLinkAbout06040028 Application
City of Carmel/Clay Township ~ Permit ii()6(J 400:; g
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
FAX
675 ~ /
PROPERTY
OWNER:
CITY
STATE
ZIP
LOCATION
&. PROJECT
INFO:
SEmON
TYPE OF IMPROVEMENT:
Cl>,.-/>lEW STRUCTURE
t1 ROOM ADDITJON(S)
o PORCH ADDmON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARr
o DEMOLITION
SQUARE J.la
FOOTAGE: ( -[ 5-3
ESTIMATED COST OF CONSTRUCTIOlt
ClUOING LAND VAlU~~ '!' - 1"'1 ~':l3
LV II:"" - ..i'j.;jL#-O'bOZfOd~i
I u (4.,<, I ,ii
PLUMBING CONTRACTOR: - 7 2006 i'! i:!
rkrnvn tt- J1~L~ ~c". /l!:!) i
Plumber's Indiana State License #: .J'
c...p 10008/ I'J I -----.--
SEWER UTIL
PROVIDER:
NAME OF lJTIUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TYPE OF CONSTRUCTION:
8rsINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
Which plumbing codes will be applied to the construction:
~ lJ.l""llational Residential Code w/Indiana Amendments
o Uniform Plumbing Code wi Indiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
E I R I ~- M f ct d ~ FOUNDATION TYPE: (Check all that apPll!8or the'f.ew
ar y e ease anu a ure - "'"
P 't Y T Y constructIon area) "L l' t.
ermI : - russes: N 0 CRAWLSPACE 0 POST & BEAM-PtJ/ ( Tt!1/(SrI
Lot Split: _Y ----V Sump Pump: _N 0 SLAB .~ R6SEMENT uJ I /(R7fJ
Does any part of the property lie within a special Flood designation area: _ Y ~ WALKOUT:_ Y ~
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 are 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 wjth, and conform to, all applicable la\vs of the State of Indiana, and the ~Zoning Ordinance of Carmel
Indiana - 1993" (Z- 289) and amendments, adopted under authority of LC. 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
o occupkd untH a Certificate of Occupancy has been issued he Department of Community Seevices. Carmel. Indiana. I
. '<I- L!E>- /0 "
Date (
(Date)
Fee Received b :
*************************
o
OFFICE USE ONLY: **********************************************
Filing Fees: .
INSPECTIONS REQUIREDRELEASED FGl5\;PfrlN~IjMpTIO
~_Footi~ ~ot~lSIllJjstallo compliance wflh all reguiatloll"
~ ~t8 ~c9la:v~cy:
~GeterBa~Final DE~' O~llM,~.~!TY SERVICES
tl CITY OF CARMEL / CLAY TOWNSHIP
U INDIANA OTAL:
# Charged Re-
Reviews
j{)
Additional Fees
Reviewed{ Approved:
S;Permits/Forms/ILP RESIDE
30