HomeMy WebLinkAbout06040147 Application
City of Carmel/ Clay Township cJ-r,ermit #:tJ{;;1J 40/17
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
PROPERTY
OWNER:
STREET ADDRESS
LOCATION
&. PROJECT
INFO:
LOT #
3~5
SEWER
PROVIDE
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TYPE OF CONSTRUCTION:
J:O-- SINGLE FAMILY
<0 TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
NEW STRUCTURE
ROOM ADDITION(S)
PORCH ADDITION(S)
REMODEL
ACCESSORY BUILDING
DETACHED GARAGE
ATTACHED GAR'
DEMOLITION
~
o
o
o
o
o
o
PROJECT INFORMATION:
Early Release
Permit:
PHONE
616~d3=
CITY
PHONE
FAX
CITY
STATE
ZIP
'5";
SQUARE
FOOTAGE:
8
ESTIMATED COST OFrCONSJRcU Of':l:-:.:::;-:;-:;'-:~."':-'" ;~::--:~-:
, ((-/:3,,"1:1 >;1'/-=>"/ i \, i
_ ...-:.;IJ ' ;:;/;. t::::KJ .....:..JJ,,; : ;
#-ObO~/~~1
LV IU:
-
Plumber's Indiana
r!--
tate license #:
Which plumbing codes will be applied to the construction:
~ '"ternational Residential Code wI Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
~ Manufactured 2= FOUNDATION TYPE: (Checkallthatapplyforthenew
construction area) ~
Y Trusses: Y N
-0 0 CRAWLSPACE 0 POST & BEA
Lot Split: Y N Sump Pump: Y -NO SLAB
~BASEMENT ~
Does any part of the property lie within a special Flood designation area: _ Y WALKOUT:_Y ~
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 clate. Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
~,~~IlJe~nning and completing construction.
I, the undersi~6h) J5.~~&Q,!~~~sttuU?.p~~eIi1awement, relocation, or alteration of a struc~ure, or any change. in the ~se of land or
structures requeS(:~f)W'GmmrntpJitfiiQ:I1}c::t:o.ltl.ikY~tfP,!iHd'C'dR6tIb to, all applicable laws of the State of IndIana, and the uZonmg Ordmance of Carmel
Indiana - 1993" (Z~89) an~f ~W~at!~ ~iWthority of I.C 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I furthen~h t U~lli(;11HP~ fj~ITt:fuNr:<ftt.av1oeSnnected to the sanitary sewer. I further certify that the construction will not be
.u r occupie ilWWt~l:n:;'LA41-'5w tfhe Department of COm~~y s;;ces. CTel, Indiana, tj ~/o Co
Date /
OFFICE USE ONLY: ******************************** ************~***'**/*>******************
Filing Fees: <~ ,c7'O
INSPECTIONS REQUIRED: '/1
Base Inspections: ~'7? )U # Charged Re-
_ ReViews
Cert. of Occupancy: ,5 3, :;-0
()
/~ ~f'
~
'-----
C Rougli ~
Additional Fees
~P'R'I.F':
//
\
~~
.~7-06
(Date)
Reviewed/App~ vetl: Dept. of Community Services
S:PermitsjFormsjIlP RESIDENTIAL
Fee Received bv:
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