HomeMy WebLinkAbout06050197 Application
City of Carmel/Clay Township u),l,. ~ Permit #:01,0 6' 0 A ~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, 8< Two Family: New Structures, Additions, Remodels, 8< Accessory Structures
BUILDER of
RECORD:
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FAX
flc( -)). 3/
CIlY
~ l(i-o
ZIP
0,3 L-
BUILDER'S EMAIl ADDRESS
BEST METHOD OF CONTACT:
PROPERTY
OWNER:
NAME S~e-
PHONE
FAX
STREET ADDRESS
CIlY
STATE
ZIP
LOCATION
8< PROJECT
INFO:
LOT # SUBDIVISION NAME
LA u4A- VI $I~
ADDRESS OF '3NSTRUCTION { I/u 1/ A ellS r~ b II
SECTION
~/::;==>
SQUARE .., .,
FOOTAGE: r;...
TYPE OF CONSTRUcnON:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
RESIDENTIAL (For
Additions, Remodels, Etc,)
ESTIMATED C~OF'~QN?TfWCtlON:,---;:;-';;-;:7-;;;~ :--, 1
(EXCLUDING '-\'IND VALUE) (C~&-' i 'pz;)."cr' 'I !'i '.!
II! '\\ t=::J ......-:o~ ,.,... _:I! ,\t
III II' 'I' ;'1
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET ~ J ~'. I) Ii : iii'
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE): IV. \ . I I I
, 1'. \ r :! I.
TYPE OF IMPROVEMENT: PLUMBING CONlrlMcr Iii U j \
iW wi L_'
o NEW STRUCTURE 1oIA- I '
~ ROOM ADDITlON(S) Plumber's India+a State License #: I
B ~~~~~FOR CONSTnUCTION
o ACC fflLiNfllP"anoqg'i9lU\I'III1IJi~miltI'cfflH be applied to the const,udion:
o DETACHED G.olJ(ijstClllnd COCllltlilo1illi911al Residential Code wI Indiana Amendments
B ~~~~~~~l];;)fo\iiPll.llGEiiS:Ode wI Indiana Amendments
V1rr1il1"1 / coo'-ro~s~n Code)
M f ct d W; . I !;b~DATION TYPE: (Check all that apply fo, the new
/ anu a ure .
_Y ~N Trusses: Y N co.:tructlon area)
V; - X ~ CRAWLSPACE 0
Lot Split: _Y _N Sump Pump: _Y _N 0 SLAB 0
Does any part of the property lie within a special Flood designation area: _ Y ~N
f41IY/t.:=.L-
WATER UTILITY
PROVIDER:
CMMEL
SEWER UTILITY
PROVIDER:
~
PROJECT INFORMATION:
Early Release
Permit:
POST & BEAM
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 ISO days ofthe date of issuance of the building permit. and rou d (Certificate of Occupancy issued) within IS months ofthe
issuance date. Class I structure permits are subject to the General Adm' i t riOf Indiana (See 675 lAC 12) regarding expiration
time frames for beginni ". " 't . W
1. the undersigned, agree ~hat any co.nstru~(ion, recon~truc(ion, cnlargement1,relocafioil;"Ii.I.'.' e_ -J t _ .~c. hange. in the use of land or
structures requested by thIS apphcanon v.. 0 ly WIth, and conform to, all applicable laws of the State _. 'I , e ~Zomng Ordinance of Carmel
Indiana -1993n (Z~ 289) and ndment adopt d under amhority of I.c. 36-7 et seq, General Assembly of the State na, and aU Acts amendatory
thereto. I further . y th, only kitch ,bat, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
use edu ertificateo c pancyhasbccnissucdbyt Dcpmrn:nir:r.rnuniZ:;~c~c~kdiana. ~/;.t,/c; b
Date' I
~
Reviewed/Approved: Dept. of Community Services
S;Permits/formS/ILP RESIDENTIAL
INSPECTIONS REQUIRED
OFFICE USE ONLY: *************
Lower Footing
# Charged Re-
Reviews
Meter Base
Additional Fees
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