HomeMy WebLinkAbout06050102 Application
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City of Carmel/Clay Township t>>l' Permit #:an50IQ;L
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
STREET ADDRESS .
D.;l~ \..Ur( I ~
NAME
-1"73-9'7 '/
PROPERTY
OWNER:
,CCYY\
PHONE
BEST METHOD OF CONTACT:
e -rf\C>J-.R (y &..U
o
L(5-'-17()/
FAX
LOCATION
&. PROJECT
INFO:
SQUARE
FOOTAGE:
SEWER UTILITY ESTIMATED COST OF CONSTRUCTION: J, II 1\710 .--
PROVIDER: (EXCLUDING LAND VALUE) -\p ~~~ ~-.;\ \
NAME OF UTILITY EXCAVATION CO", CTO; PLAN COMMISSION I BZA / BPW DOCKET , ~.r) L.~_:~.'~ ~ '\:!L~\\\\\,'\ \' \
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE): r:::::::\~ (~ \\
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONT R: 0^c WJ \
o SINGLE FAMILY 0 NEW STRUCTURE N- \\'" ~ ~~ 'I I) i ') II:::!)
o TOWN HOME -T"}" \/'. 0 ROOM ADDmON(S) Plumber's Indiana State li ense #: ~____'
o TWO FAMILY jA:/CS--Iii!'" PORCH ADDmON(S) \\~ "'\../---
# of units: ____ 0 REMODEL ,--
o MULTI-FAMILY 0 ACCESSORY BUILDING Which plumbing code. will JrPI,ed to lbe constr~cti~n:
.J # of Units: 0 DETACHED GARAGE 0 International ReSidentiarCo;';w/Indiana Amendments
lJ{) RESIDENTIAL (For 0 ATIACHED GARAGE
Additions, Remodels, Etc.) 0 DEMOLmON
o Uniform Plumbing Code w/lndiana Amendments
(MUlti-Family Construction Code)
PROJECT INFORMATION:
Early Release
Permit:
FOUNDATION TYPE: (Check all that apply for the new
construction area)
ri
o
POST & BEAM
BASEMENT
WALKOUT:_Y_N
/ Manufactured /
y ~ Trusses: _Y ~N
/. 0 CRAWLSPACE
Lot Split: _ Y _N Sump Pump: _ Y ...\L.N 0 SLAB
Does any part of the. property lie within a speciaf1fo~d'designation area: _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 day~Q1fh.e.~acf,QU.s~~ oJ...t.l1f...ll~. ,']il P;;Q1.i.~~~. must be completed (Certificate of Occupancy issued) within 18 months oEthe
issuance date. Cta\!;~ern\iln[\t4K:Jj\i!~:dnwQ.-h~dministrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
. Subjecllo OtlmpllnnCO.~l#.l~~~.!jning and completing construction. .
I. the underSigned, agree the1f<er l1l1". ~ 1\\9'. . ~. ~. 8fln.,,:CI11a rg emem, relocatIOn, or alteration of a structure, Of any change III the use of land or
st~ctures requestr4rb~s,appJ.iR~U')N.iI,J:C' '., i~',:.a~<flI~to, all applicable laws of the State of Indiana, and t?e ~Zoning Ordinance of Carmel
Indiana - 1993" (z'4~fand~n~~r!f~.. t.,'. d~~cY.r',l1'5fR::. 36-7 et scq, General Assembly of the State of IndIana, and all Acts amendatory
thereto. I furth<0lel'iVy@pt ~jjll.Pl}I(DlDMI6Of@WNSHI~cted to the sanitaty sewer. I further certify that the construction will not be
used or occupied until a Certjfic;;t~~f~f47,{ has been issued by the Department of Community Services, Carmel. Indiana.
31j);L..~N;';",::- . ~LLsa..(\ exam -dJ511O~
Signature of Owner or Authorized Agent Print I Date
OFFICE USE ONLY: **** **** ;"******* ******* **;i~~;;::s~***** *******~*~**~*** *************
INSPECTIONS REQUIRED: . ~ _ . - ~/)
Base Inspections: v # Charged Re-
Lower Footing Under Slab ,Reviews
r;;:a~ Cert. of Occupancy: 0-3. )0
~ '.'.I.F., ~ ~-""-
TOT~ 1'03,/0.
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FeHeceived by. I '
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Reviewed/Approve: Dept. of Commumty ServICes
S:Permits/Forms!ILP RESIDENTIAL
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