HomeMy WebLinkAbout06050174 Application
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City of Carmel/Clay Township \..j) c- Permit #: 0&050 /1q
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, S. Two Family: New Structures, Additions, Remodels, S. Accessory Structures
BUILDER of
RECORD:
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FAX . -
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BUILDER'S EMAIL ADDRESS
BEST METHOD OF CONTACT:
PROPERTY
OWNER:
NAME
PHONE
FAA
LOCATION
s. PROJECT
INFO:
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SECTION
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SUBDIVISION NAME
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SEWER UTILI)-{ WATER UTlL"7J
PROVIDER: G PROVIDER: C; fJr1:--.
NAME OF UTILIlY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):)(
5 UARE
I OTAGE:'7] '" 0
ESTIMATED COST OF CONSTJijJCTION:
(EXCLUOING LAND VALUE).Q , tJ 0 d cT c!
if icko r
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
~ SINGLE FAMILY ~Nkw STRUCTURE
o TOWN HOME --=::-;~ ~7 @ , OM ADDITION(S)
o TW~l~~ ~ ~~ P CH ADDITION(S) ."
# on~~~ 0 R ODEL A
o MUL f u' , A 1\)\)00 SSORY BUILDING
# 0 l\J~ '2. 't 0 HED GARAGE
o RESID' (Fo ~lTA HED GARAGE
Addition' ,R odels, Etc.) 0 DEM ITION
E IN RM
,/ Manufactured / FOUND~TION TYPE:
P't Y N T Y vN constructIon area)
erml : russes:
- - - - 0 CRAWLSPACE
Lot Split: _Y ~N Sump Pump: ~ Y _N 0 SLAB ~~ /
Does any part of the property lie within a special Flood designation area: itY Y ~N
XCCtv6-tlf\: .
PLUMBING CONTRACTOR:
~ S C-l1.J I e.r
Plumber's Indiana State License #:
<{loS-::;] G)
Which plumbing codes will be applied to the construction:
[ D,...International Residential Code w/lndiana Amendments
{ ,!;!J Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
(Check all that apply for the new
~
POST & BEAM I
BASEMENT . / Y
WALKOUT:J~_J _N
For Single FamYy and Tvv,9,Family dwellings, additions~emodels, and/or accessory structures, this permit is valid only if construction commences
within 180 ~~~PePr€€JH-~pdQ}Jand must be completed (Certificate of Occupancy issued) within 18 months of the
issuance dates a~M'flructurm~'rm~dWIWP.iiHtr;ygb~8d Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
U ee 0 CO I ,t.iwHfrgmes for beginning and completing construction.
t, the undersigned, agre&:tbS:tit.,~h\f&kQ&'~, r't~t~~Qi~*'l.1..~rgement, relocation, or alteration of a structure, or any change in the use of land or
structures reqE~~MkilN4~y~~am to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana -'199.J.: . ~ 8 ... lWE5~~ts,f1r;lsptflt.\pnPP\WM'SH1pC. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I fur\li( cr. th fiHl1~~lt~nld flo'or mains are connected to the sanitary sewer. I further certify that the construction will not be
",used occupied until a Certjficat~cy has been issued by the Department of Community Services, Carmel, Indiana.
.It; 'Xi c;$JJ~'~ Sco-r+ &rr+-ro.. e.r S'/...zY/oiP
'. ~~. Signature of Owner or Authorized Agent.. Print Date
~~ OFFICE USE ONLY: ********~*** ***91***.***.*.f':1?** ************1*1****9*******************
~ '2 0 '3 'FiTif1!{ Fe . !j 0::<.::> . () ()
INSPECTIONS REQUI ED: :J t '
~ '1 "33 00 # Charged Re-
\ Upper Footi' L _~ootm /"0 Reviews
\ Cert. of Occupancy: J
'o~ Site
\,__n -j P.R,I.F.:
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(Date)
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Additional Fees
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\prove ept. of Community Services
!LP RESIDENTIAL
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