HomeMy WebLinkAbout06060035 Application
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. City ofCamul/aoy Township \y {g .~ ,,~uObOb003':>
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
ADDRESS DF CONSTRUCTION I,-C=:--;::--~~'=~:-:--.--;-;- -;-'-.-:-;--;:--::--
.3 y ('1 0; ,,)(:."\\ :.ft~ In : L "-"-~;" ;
WATER UTILITY I iJ)-j II .-- - --ESTIM~ti:D ;~qST OF CONSTRUcnON:
PROVIDER: 1,"0 j'L I'" (EXCLU~ING If'.ND VALUE)
,. ,II 1.1 lit
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / iliA f!BPW D - ~ i ' III
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC P . Il\! S (IF APPLICABLE): 0 ;: ~_
...DER of NAME
':ORD:
NAME
PROPERTY
OWNER:
STREET ADDRESS
LOCATION
& PROJECT
INFO:
LOT' /0)
SEWER UTILITY
PROVIDER:
( rtt w p
TYPE OF CONSTRUCTION:
~INGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MUlTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMA110N:
Early Release
Permit:
//
PHONE / 76 -.2 r (, 7.--
FAX Y '10- Y22J/
. fPr'VO Ie
ZIP
Cff,2YcJ
- /"'< ""'/ /
FAX
CITY
STATE
ZIP
SUBDIVISION NAME
x
SECTION /"
ZONING: f? - 2-
SQUARE .
FOOTAGE:~;?.s-~
7~~0,..A
TYPE OF IMP OVEMENT:
o----NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
o~
(}()<J.--
;J.8
icense #: ~ -.", ~ . 1:
() )- f'" '. -.: r- >;>~
Which plumbing codes will be applied to the construction!"' .t,:, ~1;,
C31i1temational Residential Code wI Indiana Amendments",,',
'.
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
Plu
Manufactured ~ FOUNDATION TYPE: (Check all that apply for the new
/" construction area)
_Y -'::::::N Trusses: ~Y _N
.....-;:. / D/CRAWLSPACE
Lot Split: _Y _N Sump Pump: _Y _N G'SLAB
Does any part of the property lie within a special Flood designation area: _Y ----N
o I POST & BEAM
a BASEMENT
WAlKOLIT:_ Y ---r(
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structureS, th~~flIllit is valid only if construction commences
within 180 days of the date of issuance of the building permit, and must be COmw.'1ff~(,.,~ccupancy issued) within 18 months of the
issuance date. Class I structure permits are sub~ect to the Gen.eral NIB1~' 'iG~~ 1,~~nttIiana (See 675 lAC 12) regarding expiration
tIme frallll1l~\il a IIll'IfI\l1k .li'l'IictIon.
I, the undersigned, agree that any construction, reconstnt\ ;:"~Wf@@fflft.l r\O~\teoG~~'qf ri~re, or any change in the use of land or
structures requested by this application will comply "rith, #-~:I~'~ l~ftJi~ ae.a\l:~~ and the ~Zoning Ordinance of Carmel
Indiana -1993n (Z-289) and amendments, adopted under authoritL.-o" k~d~HI ~is~MSI'MIe of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen, bath, and floor ~ ic ~iF s~ i1f.\'~r~.ftt1rther certify that the construction will not be
used or cupied ~certjfjcateofOccupancYhas bS~~}lfj; ~k~M t lS..ommunity Services, Carmel, Indiana.
?~ Gtri' " l\~~ Q a:( -2-d'}'
nature of Owner or Autho zed Agent ) Pri t Date
OFFICE USE ONLY: ***
(Date)