HomeMy WebLinkAbout06040068 Application
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City of Carmel/Clay Township u) ~ . Permit #~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME
~.d
STREET ADDRESS
II. 4.}, ['
BUILDER'S EMAJl ADDRESS
PROPERTY
OWNER:
NAME
STREET ADDRESS
<
LOCATION
&. PROJECT
INFO:
LOT #
).30
SUBDIVISION NAME
V:/It. .(
ADDRESS OF CONSTRUCTION
SEWER UTILITY
PROVIDER: C
NAME OF UTILITY EXCAVATION CONTRAcrOR; PLAN COMMISSION J BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUN1Y WEH.....ND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
/
TYPE OF CONSTRUCTION: -<"~
ri SINGLE FAMII);~~
o TOWN H~f)lL <:~
o TWO.F~,MjUY ....M
# oF-units:/' '?l V-
o MULT1~, "MI~LY \
# of,U . :
o RESIq~ff (f r
Addition&, ode, tc.)
,
F IMPROVEMENT:
NEW STRUCTURE
OOM ADDITION(S)
P (l-CH ADDITION(S)
REMODEL
ACcESSORY BUILDING
/
DETACHED GARAGE
ATTACHED GARAGE
DEMOLITION
PR
PHONE
FAX
CIlY
STATE
m,
ZIP
BEST METHOD OF CONTACT:
..v1
PHONE
FAX
CIlY
STATE
ZIP
"
SEmON
12.00 -B
o
SQUARE t3" e"
FOOTAGE: ~
ZONING:
ESTIMATED COST OF CQNSTRUcrrON:
(EXCLUDING LAND VALUE) ~ ~7t::?, (JdO
PLUMBING CONTRACTOR:
?I-VJI4I3 "VtJ/lt:S I JJI#I feIJld
Plumber's Indiana State License #:
1%{)Odc(
Which plumbing codes will be applied to the construction:
;fl5 International Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check aU that apply for the new
construction area)
Manufactured
Trusses: _ Y -lL-N
o CRAWLSPACE
Lot Split: _ Y ~N Sump Pump: ls:- Y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _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 are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
time frames for begmnmg and completmg construction f'\t\I
I, the underSigned, agree that any constructIOn reconstructIon, enlargement..Lelo~, ~ ~~tfQlJGrJMf1 ~hange m the use of land or
structures requested by thIS applicatIon will comply WIth, and confor~~~~ U~Mtlie ~m~~lr~1!Jlutibh8"Zomng Ordmance of Carmel
IndIana -199r (Z~289) and amendments, adopted under authOrIty of ISul5l8Gt tOl~CMJftlfut'JltplrllE;..$e~e of IndIana, and all Acts amendatory
thereto I further ce Ify tha y kitchen, bath, and floor drams are connected tOc5f.~6L~fi."k.P'qCfu ~teirJ~ ~e constructIon will not be
used or Ie n~~cate of Occupancy has been Issued by tbe Df'('jt:'eed~~*YYe&ESltl!.tli:i~nd!ana
V iP~<lgJF~ME~OWNSH'P- ~-13-,'t
Signature of Owner or Authorized Agent ~~. 1 N 0 \ANA Date
OFFICE USE ONLY: ******* **** **** ***************** ******** *****?:.!Jf**~ ****'*~ *************
Filing Fees: I ^' ,::;J 1, GO
INSPECTIONS RE UIRED: . p,' 't-'7'" _1! # Charged Re-
Base Inspections: ,_ /, ~ v'
ower Foo . g Under Slab '. .-'/) Reviews
~ Cert. of Occupancy: ....
~~ /final Site
~~ _ P,R.LF,:
ReViewe~~. Of~ces (Date) i..
S:PermitsjForms!ILP RESIDENTIAL Fee
~
o
~
POST & BEAM
BASEMENT
WAlKOm:_ Y ?I" N