HomeMy WebLinkAbout06040040 Application
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~itY of Carmel/Clay Township cfMpermit #OfIY/P()LJD
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICA;TION
For Single Family, Multi-Family, 8r. Two Family: New Structures, Additions, Remodels, 8r. Accessory Structures
PROJECT INFORMATION:
Early Release f Manufactured'/
Permit: Y , N Trusses: ~Y _N
\j , 0 CRAWLSPACE
Lot Split: _y' N Sump Pump: ~Y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _ Y
BUILDER of NAME
RECORD:
H-01JVI6
I2d
BUILDER'S EMAlL ADDRESS
PROPERTY
OWNER:
NAME
STREET ADDRESS
LOCATION
8r. PROJECT
INFO:
LOT # SUBDIVISION NA
SEWER UTILITY 11
PROVIDER: u1euJD
WATER UTILITY
PROVIDER:
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):
N:
TYPE OF IMPROVEMENT:
~NEW STRUCTURE
-0 ROOM ADDmON(S)
o PORCH ADDmON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
o
o
o
o
Q6J.
FAX '&j!;;_t.j ;)8L
CITY
IC~ _
i r') STATE~ --;::----".ZIP',___
I' C"" ""'-, .c::::' r, ----- .,-.-
j'" I I~ \.1:./, Ic'eo 11 \,' ,17 -",
: I I r---._--.~.__'-~:';;;l..1 v/ ! ('~.
I' lJ I ~-..~_
ilioi / ZONING:
U'
l
"II, :'i
.1. ii'
I;I{ Ii!
Ii .i!
PLUMBING CONTRA OR: 0
I?[L~/ C, r,9l-'
Plumber's Indiana State Lice,?,- .
/ lJCi9D
/
Which plumbing codes will be applied to the construction:
.ft'IntematiOnal Residential Code w IIndiana Amendments
o Unifonn Plumbing Code wlIndiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o POST & BEAM
~ BASEMENT V
N WALKOlJT:_Y-----L\-N
For Single Family ancJTwo F~ ~~c4ll~oAs, remodels, and/or accessory structures, this pennit is valid only if construction commences
within 180 days of t:ij.e date ~'btQM,~ iGQN&a-~cJ@.NFted (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I S, tructu8J.tlaj:iiiMsk>>e~lJptmbtJ~~~Fm-qf~~u~es of the Stat~ of Indiana (See 675 lAC 12) regarding expiration
. of Stmf!' HiWlef wr~beo'innrn;ran'll"i'Oll!pI!ltmg construction,
I, the undersigned, agree thaikE' rufQ.~'~_),\Il.s~~p~~E.'! ,relocation, or alteration of a structure, or any change in the use of land or
structures requested by this a on wH:l'W~VkWfeHrfI W~ws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993" (Z-289) and ~ 0 au', ral Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen, ~~~~~~ ary sewer. I further certify that the construction will not be
used 0 occupied until a G . cate of oc~~;:::~; ~Niled by the Department of Co!pmunity Services, Carmd, Indiana.
;IOY~_)'" J G (CJCP llt)-rf;;
Print Date
OFFICE USE ONLY: ** * ***** **** ********* * *** ************* * * ***** * ~***** ********** *** *** ***
Filing Fees: 'd3. (' 0
INSPECTIO UIRED: '7 7'~ --tJ # Charged Re-
, Base Inspections: -.z u':>'
Lower Footing J Under Slab ...... '/tJ Reviews
~ Cert. of Occupancy: S3,,:>
al Site 0 ()
P ,R,LF,: cl. (, Additional Fees
;;? 3J'~ ,/ cJ
~
,
C r<t-J~ H)~ 'Y-It-oh
Reviewed/App ved: Dept. of Community Services (Date)
S:Permlts{Forms/ILP RESIDENTIAL
Fee