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HomeMy WebLinkAbout06050009 Application City of Carmel/Clay Township CJ~rmit #ObtJ5000 Cj RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures BUILDER of RECORD: PROPERTY OWNER: LOCATION LOT # & PROJECT INFO: SEWER UTILITY WA R UTI~ PROVIDER: PROVIDER:,~ V NAME OF VTILfTY EXCAVATION CONTRACT ; PLAN COMMISSION / BZA I BPW DOCKET NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE): TYPE OF CONSTRUCTION: ;:i( 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 ADDITION(S) o PORCH ADDITION(S) o REMODEL o ACCESSORY BUILDING o DETACHED GARAGE M ATTACHED GARAGE o DEMOLITION PLUM~ C~RACTOR: ~ I. "I;..z; c- Plumber's Indiana State License #: -pC ~i'9o t'J/ / {, Which plumbing codes will be applied to the construction: ~ International Residential Code wI Indiana Amendments o Uniform Plumbing Code wI Indiana Amendments (Multi-Family Construction Code) PROJECT INFORMATION: Early Release Manufactured ,,/ Permit: Y N Trusses: Y ~ . ./ ./ 0 CRAWLSPACE 0 POST & BEAM Lot Split: Y ~N Sump Pump: ./ Y =N 0 SLAB / )8r BASEMENT /' Does any part of the property lie within a special Flood designation area: _ Y ~N WALKOUT:_ Y ~ For Single Familx,.wd l.""~tmHJ~flfi1!f;CMS:-TdI1llGnb, ,nd/or accessory structures, this permit is valid only if construction commences within 180 dayfil::t:~lii? dfYssua;y.s...e o~i~h'N1WPti\r~t.mw~must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. CI6ij1biOOH:Nfe:~lli"'J:t gU~Fy.t~cMf;eneral Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration of Statc"ano q'rfflle'1r~PitUSI' ing and completing construction. I, the undersigned,~$i1 W ee:~ttttdti(t~,'t~ ent, relocation, or alteration of a structure, or any change in the use of land or structures requeste~this lUCi,lt.lQQ. will c~ ~~:-p:~ ~Rll apphcable laws of the State of Indiana, and the ~Zoning Ordinance of Carmel Indiana -19 ~, Gdinoo.ry!~pt~ _upder authority of r.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. urther ti t only kitch l:AWAloor drains are connected to the sanitary sewer. I further certify that the construction will not be used 0 occupi erti!icate Occupancy has heen issu y t ?e?rr' Carmel, Indiana. .,5- L ~ e::. Signa Print Dat"~ ONLY:***********************************************~************************ Filing Fees: J 0/3 - bO INSPECTIONS REQUIRED: f' - Base Inspections: c.=2 -; 7- :J 0 # Charged Re- ReViews Cert. of Occupancy: r3. SO '~.(T~:,;<6/;t,60S. G:~'- ~~a~ Fee Received by: ower Footing Under Slab ~V Upper Footin l Reviewed/Appro d: Dept of Community Services S;Perrnits/FormS/ILP RESIDENTIAL $-5~o.6 (Date) FOUNDATION TYPE: (Check all that apply for the new construction area)