HomeMy WebLinkAbout06040113 Application
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City ofCarmellClay Township Permit IItk1 rrDI13
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
N
PROPERTY
OWNER:
~Y>1
LOCATION
& PROJECT
INFO:
SEWER
PROVIDE
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNn WELL AND/OR S PERMIT #'S (IF APPLICABLE):
o
o
:::(3;:
PHONE
FAX
CITY
STATE
ZIP
SEmON
L.(
ZON1NG:
I
SQUARE
FOOTAGE:6 1-'8 5
ESTIMATED COST OF CONSTRUCTION:
EXCLUDING LAND VALUE) / 9 ~
Wt
015
c..... :# tlho'fo/ll
PLUr:'B}NG CONTRACTOR: _
fldfr;21'n rn O'<'~ n S' ..f-.v1 C.
Plumber's Indiana State License #:
C-P / (){x:>c) 10 I
.
Which plumbing codes will be applied to the construction:
~mational Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family ConstructIon Code)
N:
, ~\ _ Manufactured ~ FOUNDATION TYPE: (Check all that apply for the new
Y N Trusses: Y' N construction area) CfiJ/ (
o CRAWLSPACE 0 POST & BEAM-tJt j1/ sh eO
Lot Split: _ Y N Sump Pump: Y N 0 SLAB ~ BASEMENT y.2,""-Fnr '.&<th
Does any part of the property lie within a special Flood designation area: Y ---0 WALKOUT: . -----r"
For Single Family ancU'.wp fapli.bubYe,lli}l&S, a.dAiti{>fl::.-M1PPJ:JSr~~Qr accessory structures, this permit is valid only if construction commences
within 180 days of tKtC~t:8.~j""df..Hi~ b",JMnig:pefmH1,~Ib.UM be completed (Certificate of Occupancy issued) within 18 months of the
issuance clate. Class I 60t0feotpennb-Sl'bpii~t'.wl'hatttmga1latl6li\Sstrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
of State ancFmdm~~srginning and completing construction.
I, the undersigned, agr~>~~WHf\Wf9Ril~~f~~~.r~~~relocation, or alteration of a structure, or any change in the use of land or
structures requested by Hi~pliMJon~ t~?y'M H, lncH:hTmXrt tt'bUPa,Eplicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993" (Z- 28~tIrar.r@FlI€Af,\I\I\>iij:ld,u~lrAl(hqr@wNSliltld ,eq, Genna! A"embly of the State of Indiana, and all Act, amendatory
thereto I further certIfy that only kitchen, brFJ1FYl,^-Q...qC)\ drams are connected to the samtary sewer I further certify that the construction wIll not be
occupIed untIl a CertIncate of OcdJjYMtfHaV'Bcen Issued by the Dcp,artment of Commumty ServIces, Carmel: IndIana J I /
- c--l.,V1ICC-f' ~uArJn{./lr t-( /I~/Oc",
~ Date' r
OFFICE USE ONLY: *************** *** *** *********** ************tjJlI)*W**~ ***************
Filing Fees: V ?-- ...) d
INSPECTIONS RE UIRED: "7 7"7. ~t1 # Charged Re-
Base Inspections: d:. /. "- V
"'--'3 ReViews
Cert, of Occupancy: . ~ - ,<6
rJ()
5d-/.5'0
--c;~
P.R,I.F,:
,
C yo'" ~~ !--iJSa-v- t.;-2'1-1)(.,
Reviewed/App Dved: Dept. of Community Services (Date)
S:Permits/Forms!ILP RESIDENTIAL
Additional Fees