HomeMy WebLinkAbout06050075 Application
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City of Carmel/Clay Township .'\ermit #: (J ~ ()SOO fS
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-F 0 Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME
STREET ADD
PROPERTY
OWNER:
NAME
STREET ADDRESS
LOCATION
&. PROJECT
INFO:
PHONE
FAX
CITY
STATE
ZIP
BEST METHOD OF CONTACT:
FAX
CITY
STATE
ZIP
ZONING:
SEWER UTILITY /) /l, J, /V) II I
PROVIOER: L LUU I LIt...A-....
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR couNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
_y--.LN
Lot Split: _Y..AN
Does any M.~
For Single <.it~;UIflHdRl~~g~j:lels. and/or accessory structures, this permit is valid only if construction commences
within 180 days of ofeStat6~<tocaf fk>~!\jng permit, and must be completed (Certificate of Occupancy issued) within 18 months of the
issuan~~ da@f!lb:"fi O~NfTY~~,AAW~~DI=ral.Ad.ministrative Ru~es of the Stat~ of Indiana (See 675 lAC 12) regarding expiration
^",'~rITV ' .' ,'V '.,;' tff-.'it:lf1.lHt~~egmmngandcompletmgconstructIon.
I, the und~gm:cQIie~;JrG-W~~~rgement, relocation, or alteration of a structure, or any change in the use of land or
structures requested by this app.MJi1rwfi\1.A.orfiPlY;\vithif~~-;rt~Morm to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana -1993" (Z~ 289) and amend'me!l@~lOdpted under authority of r.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen, bath, and floor drains are connected tn the sanitary sewer. I further certify that the construction will not be
used or occupied until C:ereificate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
I WIlA/t/JJJ HIA/JII/l/A.I
Print
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
~ TOWN HOME
o TWO FAMILY
....Jt.. # of units:
~. MULTI-FAMILY ~
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit:
TYPE OF IMPROVEMENT:
~ NEW STRUCTURE
o ROOM ADDlTlON(S)
o PORCH ADDlTlON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
Which plumbing codes will be applied to the construction:
o International Residential Code w/Indiana Amendments
~ Uniform Plumbing Code wi Indiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Sump Pump:
.xy N
V 0 CRAWLSPACE
- Y -A-N y;! SLAB
ood designation area: _Y )( N
o
o
POST & BEAM v:
BASEMENT
WALKOur:_Y_N .
OFFICEUSEONLY:************************************************************************
~ Filing Fees: te / '7. 0 ({)
INSPECTIONS REQUIRED: (;~1I ., 72 ~-o
~~ Base Inspections: ,,<.. _~. U # Charged Re-
~ppe -Footi Lower Footing 53 6' 0 ReViews
~_ Cert. of Occupancy: '
~ eterBase inal SA 1 00 ..
== $_1 "~/~~'/;j1'i75.00~""-
ReviewedjApp 0 d: Dept. of Community Services (Date) ~~~
S:Permits/forms/IlP RESIDENTIAL Fee Received by:
5- / - tJ/;;
Date