HomeMy WebLinkAbout06050186 Application
City of Carmel! Clay Township Permit #: Ou. D5 () r '3 Co
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
r.. Manufactured ~
____Y ~ Trusses: <-Jc) N
'/,;'\ 0)---- 0 CRAWLSPACE 0 POST & BEAM
Lot Split: ____ Y ~ Sump Pump: ____N 'CJ SLAB 0 BASEMENT ____._--,
Does any part ofthe prope .tlI~G:TdotllOd designation are;': ~ Y ~ ~:-~t~~?o/~- y.:.;>:: N
F::~~~~~t~ .: _. jQ;~( sliffll:"'~.' ~~f~~~~w~;t;~s~rb:c~~~~;~r~~(~::t~~;::,~l~(~~~~~<!p's~N~~~~r::"I~~.th~~~::
issuan~e date. Class I ~_dit~ , _ ernt.\<VKt'\~(.9ifl"J. Administcativ.e Rules of the State JtinlJ!,\"a (See 675 lAC 12}~e~rding ~xPi~ation
. f"I~i=lT' Fe,1VI11ItV": .~l\IpqS\<iWoingandcompletingconstructiOII.\\\\\ \lAY 24 ZullO qu'"
I, the undersig~ f":~\EcFG~lmHtfcli~m, enlargement, rclocanon, or alteration of a sbcnne, or lHy cbange in the use of Idfid or \
structures req'0\i " IS ~dit\<l\~Nt1Ally with, and conform to, all applicable laws of the State d\IHdi~k, and the "Zonil)gDrdinancc'6f Carrrlel
Indiana -1993" (Z:289) and amendmalf:~l~p~ea under authority of I.c. 36-7 et seq, General Assembly of th~Stat~'of-lnaiana,a;d all Acts amendatory \
thereto. 1 further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I furtHer certify that the c~~l:tion.will'not'he
r occupied unt;] a CertiEicate of Occupancy has been iss the Departme'3-;m~ity seb:;ccs..Carmel:rndiana6! ;;:(d.1o ~
OFFICEUSEONLY:**************************************************1~*~******************
Filing Fees: .6 77' &, 0
INSPECTIONS REQUIRED: . -, "'-'7 -0
E9 Base Inspections: ~ / -' :>
pper Foot, g
. Cert. of Occupancy: ,')5. ,,--0
Rough In /., / / 0 /\
P.R.LF.: ~ 10_ _V
.
c2;2Ch. to
5),
BUILDER of
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
:SET ADDRESS
LOT #
SEWER
PRQVID R:
NAME OF lIT1 E VA CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
o SINGLE~A , " ~EW STRUCTURE
~TOWN M ~~ _J 0 ROOM ADDITION(S)
o TWO FA 0 PORCH ADDITION(S)
# of units: 0 REMODEL
o MULTI-FAMILY 0 ACCESSORY BUILDING
# of Units: 0 DETACHED GARAGE
o RESIDENTlAL(For
Additions, Remodels, Etc.) 0 ATTACHED GARAGE
o DEMOLITION
PROJECT INFORMATION:
Early Release
Permit:
.
"
..;,.,
ature of OWner or Authorized Agent
ZIP
</-&03
BEST METHOD OF CONTACT:
C' d
FAX
CITY
STATE
ZIP
ZONING:
:sf
SQUARE
FOOTAGE:d8"6~
PLplj'IBING CO ~C~OR: _
~/YY1 <T ~ -J.tK)
Plumber's Indiana State License #:
C.f / OCX)<5 /0 /
Which plumbing codes will be applied to the construction:
\i Tntemational Residential Code wjlndiana Amendments
o Uniform Plumbing Code wjlndiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Date
# Charged Re-
Reviews
Additional Fees
C!.. ~ 11ii,s ~ ~ ~U - 6t,
Reviewed/Appr ved: Dept. of Community Services (Date)
S:Permits/formsjILP RESIDENTIAL