HomeMy WebLinkAbout06040133 Application
\ City of Carmel/Clay Township vA. Permit ttQdJ4D13?>
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
PHONE3/7- 57!i-64t7
FAX 3/7 - '575-'1'3 .
ZIP
038
339 -5?/Cf'
STATE
BUILDER'S EMAlL ADDRESS
PROPERTY
OWNER:
NAME
B'JS:!: METHOD OF CONTACT:
Ko - 3i"1-
PHONE
FAX
STREET ADDRESS
CITY
STATE
ZIP
LOCATION
& PROJECT
INFO:
ZONING:
S-/Ccu
SQUAR
FOOTAGE:
SEWER UTILITY/",
PROVIDER: L-- A
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET /)
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE): -
TYPE OF CONSTRUCfION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
~ NEW STRUCTURE
o ROOM ADDmON(S)
o PORCH ADDmON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
Which plumbing codes w' "iI'ppli..... tn th.. ~ndTu~on:
~ International Residential Code w/lndiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release
Permit:
Manufactured X. FOUNDATION TYPE: (Check all that apply for the new
..J construction area)
_Y ~N Trusses: _Y N
X V ~ CRAWLSPACE 0
Lot Split: _Y _N Sump Pump: _Y ~N 0 SLAB 0
Does any part of the property lie within a special Flood designation area: _ Y -X.N
POST & BEAM
BASEMENT
WALKOUT:_ Y --2L.N
For Single Family ~r)Y~ F_amily dwellings, additions, remodels, andlor accessory structures, this permit is valid only if construction commences
within 180 days ~ ~aa&b6~:Jiie pf~' .~nn.i.t.. and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. ClaSO S;~ ~~re su e.b't 't6 ~~ 'G~elr~nistrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
~f ' ,.1,. nee '~fa.lJntfs:~r!btWmingandcompletingconstruction.
I. the undersigned.t"fEF,th,at an !&\~abh.QS:Eoh~, enlargement, relocation, or alteration of a structure, or any change in the use of land or
structures request~d t/y'tlli~ a doe ~H~..~~~officn.nM', all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993" (Z::+~atRj.~~optw,u~d.eA:ndl21MtY-e.no 36;7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify thai: o:dty'"ilitH:Y~:li:;. baih~oor ted to the sanitary sewer. I further certify that the construction will not be
ttPie un' a Iicate o11Q@7JlilRJi en issue t e Depanment of Community ~l'Vices, Cannel, Indiana. 4/;;l' f 0(;
Signature of Owner' t rlzed Agent Date .
***. *** * ** *** ***** **~ *** * *** * *~**** ********* **
F. mg Fees: 7 "7.r/..-,
# Charged Re-
Reviews
Base Inspections:
Cert, of Occupancy:
,:::;7 ~,.). (J(J
)'3, fO
6.00
c2 3 orr. tJd
Additional Fees
OFFICE USE ONLY: ********
INSPECTIONS REQUIRED:
Q1pper Footin9) Lower Footing Und SI
~~~~Ey
c-: -2";;-06
Reviewed/Ap oved: Dept. of Community Services (Date)
5: PermitsfFormsflLP RESIDENTIAL
P,R,LF,:
~ / TOTAL:
//{?~
Fee Received by: