HomeMy WebLinkAbout06040114 Application
City of Carmel/Clay Township oltlpermit #()bD4 011 ~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BEST METHOO OF CONTACT:
PROPERTY
OWNER:
PHONE
Ftv:
CITY
STATE
ZIP
LOCATION
& PROJECT
INFO:
Z;ti
SQUARE
FOOTAGE:~
ESTIMATED COST OF CONSTRUCDPN:
XCLUOING LAND VALUE) ':b / ~ & c;;( 0
=f:Fd.iJ'-I-O/1 ~
~
SEmON
NAME OF lfTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / aZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND QR..st:PTIC PERMIT #'$ (IF APPLICABLE):
o
MPROVEMENT:
~ STRUCTURE
R M ADDITION(S)
, '0 1'0'0'0 0 H ADDITION(S)
o DEL
ACCE SORY BUILDING
HED GARV~
ATTACHED Gf
o DEMOLITION
~
PLUMBING CONTRACTOR:
I-hw;;n 0- ~,<:; :j;;c-
Plumber's Indiana State License #:
C P /0000/<3 /
o
Which plumbing codes will be applied to the construction:
\-8-International Residential Code wI Indiana Amendments
o Uniform Plumbing Code wjIndiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release Manufactured FOUNDA nON TYPE: (Check all that apply for the "!:l!
Permit: y -0 Trusses: .6:_N construction area) ~/-
. - ,.,;i'\ .?v"I 0 CRAWLSPACE 0 POST & BEAM-W11
Lot Split: _ Y ---v Sump Pump: ~_N 0 SLAB ~ASEMENT ~ n Ish ed
Does any part of the property lie within a special Flood designation area: _ Y ----C1D WALKOUT:_ Y~
For Single Family a~~ f~y..d~~~'A4Ior accessory structures, this permit is valid only if construction commences
within 180 days on.w.Itt51-t\H'J;;;1rlurc~n- . , fu't.st be completed (CertiHcate ofOccnpancy issued) within 18 months of the
issuance date. Clas~~atrkpQGl\ffi:pl.iur!u6jtWin ~tatKmfiinistrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
of State and l..Idroe.rr€)odEfor beginning and completing construction.
I, the underSigned~a 'V'Y~~yrv~9h~}l~Kcp~Clt:!:~rjWt~t, relocation, or alteration of a structure, or any change in the use of land or
structures requested Jj IS jW.E'tfcatjM1'\(r-inl~om?!i~viti\, arltt-c'ohYor'r6'ro':""all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana -1993" (Z~ a dlra.hk&nA:frtMHUpt clU~'6urrfiHNMB:t:iIt:R' et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchenl ~~i~Jlfk1or drains are connected to the sanitary sewer. I further certify that the construction will not be
use r occupied until a Certificate of Occupancy'h~ been issued by the Department of Community Services, Carmel, Indiana.
nQVJIC~ S+-eU/'{-n6U/C V//<//6'.6
re of Owner or Authorized Agent ~t Date
OFFICE USE ONLY: ** ******************* *********** **** **** *******?-1***~*******************
Filing Fees: L S-.2... S-o
INSPECTIONS REQUIRED: ___{)
~ Base Inspections: ~?' 7. .L'
ooting Cower"Footing Under Slab , ~3 ",f rJ
'---- _ - Cert. of Occupancy: LJ
<l!tefer B~' ( Fi~al Site) /02 C/ A 0
~ ~ P.R.I.F.: f'. IL_
C -~~TAL:
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# Charged Re-
Reviews
Additional Fees
Q"",
ReviewedjAp oved: Dept. of Community Services
S:PermitsjForms/ILP RESIDENTIAL
Fee eceived by: