HomeMy WebLinkAbout06050091 Application
City of Cannel/Clay Township A ()O Permit #..t)60SDD91
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
\
.-;;/
NAME
r
BUILDER of
RECORD:
STREET ADDRESS
PROPERTY
OWNER:
NAME
STREET ADDRESS
LOCATION
&. PROJECT
INFO:
LOT #
62
SEWER lJT1Lm
PROVIDER:
WATER UTILm /'
PROVIDER: LO', /<. I't ~ /
NAME OF lJT1Lm EXCAVATION CONTRACTOR: PLAN COMMISSION 1 BZA 1 BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TYPE OF CONSTRUCTION:
c:g/SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc,)
TYPE OF IMPROVEMENT:
Q....1(JEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
PHONE :2 FAX 2<J;)- {'(I(o
)~- c;Yt/O
CITY ZIP
(; .;.)} i.( 6 2 'ru
C-(.jp" t') ",-. /
PHONE FAX
cm STATE ZIP
[...
. SECTION
(~~,--l2~
l/i-\\ i.I,' 'SQ ~ ~~_
I riP] l' UARE ,. .~'-
fit j/r- "-'---.. ___~~TAGE_~i/iF6)-
1,1 < I III II
ESTIMATED COST Of CONSTRUCTION: I r I I r ~
(EXCLUDlNGl{-NqVALU'MAY _ "u/ ~:bo.;F-
/). Iii /.' of
I( 1/ fr,t~?1fo~~-l!1&9
l-., I
PLUMBING CONTRA€TOR;____~ '\
liVe/ E-- >>. ( ft., ~:v~/~
Plumber's Indiana State License #: @) ...if ~
/U/77 7 ~ 'Yt."".>~.t
Which plumbing codes will be applied to the construction: "~
~ernational Residential Code w/lndiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
ZONING:
7
PROJECT INFORMATION:
Early Release /. Manufactured
Permit: _Y _N Trusses: ~ _N
o CRAWLSPACE
Lot Split: _Y <./'N Sump Pump: ,/ Y _N GYSLAB
Does any part of the property lie within a special Flood designation area: _Y /N
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o POST & BEAM
rg/BASEMENT
WALKOUT:_Y"""""'-- N
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 date. Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC l2) regarding expiration
time frames for beginning and completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or
structures requested by this application v..'ill comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993''' (Z~ 289) and amendments, adopted under authority of LC. 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 to the sanitary sewer. I further certify that the construction will not be
used or occupied until a erti!icate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
_ Pc flU (~ >-9-Q 6
Sig ture of Owner or Authori d Age Pr,fnt Date
OFFICEUSEONLY:************************************************************~{tf******
,T -" . ;?~r. (l6;-J'YJ..J
INSPECTIONS REQBfR6i{}SED FOR CON~flreTION J - / '
-----.. '5~1i ~nce v.tUIsaIij~m1!Il /7 7 -- 0 # Charged Re-
~ Footina .-JLower Foo,~in!t' . U ~~d LocpJoc;O~r?-' =- ___ -, ~ Reviews
; tfYSEI:t~~Y: iJ ...,. C) 0
~ tijot..rRa~" {:QEPJ OF.&QM~ WNjiP ~~
=- ~ jCIiY"OF cm:~~~ _TCW~~j/t4i:J7J ;;"~'-
Revlewed/Appr v Dept. of Community Services (Date) _____
S;Permits!forms/ILP DENTIAL Fee Received by:
--..
1.1