HomeMy WebLinkAbout06050167 Application
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City of Carmel/Clay Township Permit #:000 50lf.o7
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME11
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BUILDER'S EMAIL ADDRESS
PROPERTY
OWNER:
NAME
SAME.
STREET ADDRESS
LOCATION
&. PROJECT
INFO:
LOT #
I\~ A
SUBDIVISION NAME
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ADDRESS OF CONSTRUCTION
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SEWER UTILITY
PROVIDER: C.
~. WATER UTILITY
. . : .P~OVIDER: L
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NAME OF lfTILITY EXCAVATION CONTRACTOR;\PLAN'.COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELI..\ANO'lOR SEPTIC PERMIT #'5 (IF APPLICABLE):
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1\' II
TYPE,,oF CO,N5!RUCTION: TV. F IMPROVEMENT:
~ SINGL~FAMIL Y 1. '?J 1~~'Q 'v ~EW STRUCTURE
o TqW}'!, tlPM~t>-'\ 0 RYOM ADDITION(S)
o TW(N~~LY ~RCH ADDITION(S)
# o~'~ni\:S: 0 REMODEL
o MUL\I'FAM Y 0 ACCESSORY BUILDING
# of\Unlts: _ _ 0 DETACHED GARAGE
o RESIDE.NTtAI (For 0 ATTACHED GARAGE
Additions, Remodels, Etc.) 0 DEMOLITION
CITY
C.A-~i1g.L
STATE
(t-I
BEST METHOD OF CONTACT:
S-<gD - I ~(.,
PHONE
FAX
CITY
STATE
ZIP
SECTION
ZONING:
5-1
DR. JQ...
+
SQUARE
FOOTAGE:
ESTIMATED COST OF CQNSTR
(EXCLUDING LAND VALUE)
,
L..{So 000
A-I
PLUMBING CONTRACTO
It'! v.J'6..L L
Plumber's Indiana State License #:
_10<':'
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Wh9 plumbing codes will be applied to the construction:
r0" International Residential Code wI Indiana Amendments
o Uniform Plumbing Code wjIndiana Amendments
(Multi-Family,Construction Code)
PROJECT INFORMATION: ~
E I R I / Manufactured /: FOUNDATION TYPE: (Che~tapPIYfortNe ew
ar y e ease v , _ ",CO~5t ction area) ...... D
Permit: _Y _N Trusses: Y N ~ ->
./ Zy- ~m..,cRAWLSPACE 0 POST&BEAM ~.1
Lot Split: _ Y X-N Sump Pump: N (\it SLAB [B"'" BASEMENTJJ1!"-
Does any part of the property lie within a special Flood designation area: _ Y ~ WALKOUT:
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 12) regarding expiration
time frames for beginning and completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargemem, relocation, or alteration of a structure, or any change in the use of land or
structures requested by this application will 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 sanitaty sewer. I further certify that the construction will not be
used or cupied until ertificate of Occupancy has been issued by the De artment of Community Services, Carmel, Indiana.
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FinaI:;Ui'l~i% 00 ""~fl.tR)f#!~ f,l1I r~aulalion8 / ;;Lei 00 Additional Fees
DEPT ~:~~~;"~~~iL~~t C~i~OI[&1f fi.?(t a l b 0
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Reviewedj proved: Dept. of Community Services (Date) 'IN~ I - 0 -{J ~
i:Permits/For s/ RESIDENTIAL d by:
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11M.
Signature of Owner or Authorized Agent
OFFICE USE ONLY: *********
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S/~'l/6&'
Date
# Charged Re-
Reviews