HomeMy WebLinkAbout06050200 Application
~~
C;tyofCarmel/Clay Township rJI A Permit #:O/PO 50 2()1)
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of NAME
RECORD:
CITY
STATE
r
ZIP
q, J7r;
PROPERTY
OWNER:
PHONE
FAX
CITY
JDD L
STATE
ZIP
LOCATION
& PROJECT
INFO:
SECTION
ZONING:
s-
SQUARE
FOOTAGE: I
SEWER lITIUTY WATER lITIUTY
PROVIDER: I Ti PROVIDER: C A
NAME OF lITI EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
ESTIMATED COST OF CONSlf/JCTlON:
(EXQ.UDING LAND VALUE) R
TYPE OF CONSTRUCTION:
o SINGLE FAMIL v .l-
o TOWN HOME ~L If'-" '
o TWOFAMILv J"c.-{\'
# of units: r '
o MULTI-FAMILv
/ # of Units:
CS!1' RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
o NEW STRUCfURE
o ROOM ADDmON(S)
o /poRCH ADDmON(S)
M" REMODEL
o ACCESSORv BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
enew
PROJECT INFORMATION:
Early Release
Penn it:
/ Manufactured /
_v ~ Trusses: ~y N
Vv 0 CRAWLSPACE
Lot Split: _v _N Sump Pump: _v _N 0 SLAB /
Does any part of the property lie within a special Flood designation area: _v LN
ST & BEAM
BASEMENT /"
WALKOUT:_v~N
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, enlargement, 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 I.c. 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 sanitary sewer. I further certify that the construction will not be
u or occupied until a Certificate of Occupancy ~ been issued by the Department of Community Services, Carmel, Indiana.
, LoP.:' B.. B:RbSo/ll(y- HE/IlI;Nt: 5/;'1/('/"
Print Date
OFFICEUSEONLY:******************************************************~****************
e.,("II~ Filing Fees: I ~3. .s'V
IN~PECT10NS RE~UIRED: RE[EASIBQ;fi;\~FAUcr'm, 0 0 # Charged Re-
Upper Footing Lower Footing Under SIildIbJ8ct to compliance With all regulati?fE S- 0 Reviews
~ of ~Ifu 9fi@E~~iJes ~ _' _
~~ Meter Base ~ Sit!JEPT OFp;f{t!F1~v1UNITY SERVICES Additional Fees
CITY OF CARMEL / CLAY TOWNSHIP
INDIAN TOTAL:
Reviewed/Approved'
S:PermJtslFormsIILP RESt E
(Date)
~
FeeRecelv