HomeMy WebLinkAbout06060051 Application
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City of Carmel/Clay Township rM....,sV +>ljmJ+^,ifCob005~rmit #:01006 fJ05)
RESIDENTIAL IMPROVEMENT LOCATION PER:Mfr APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME
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. METHOD OF CONTAcr:
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FAX
NAME
PHONE )YI'- 2'1 Iz
FAX
y( - Y22
PROPERTY
OWNER:
STREET ADDRESS
ZIP
LOCATION
&. PROJECT
INFO:
LOT # c;
y
2-!5
SEWER UTIlITY
PROVIDER:
{~"-"'- ~
SION I BZA I BPW DOCl<ET
C PERMIT #'S (IF APPLICABLE):
NAME OF UTIlITY EXCAVATION CONTRAcrOR; PLAN C
NUMBERS; TAC DATE(S); ANDIOR COUNTY WE.!J.~!p7e&
_.~ ".~, '\
TYPE OF CONSTRUcnON:-;,~;- ,\~~1 -'lie i ROVEMENT:
r~~~:!r~~~f?~:_:;;~-:~:~-l~i)1 ~~E;~~)
# of Units: ~ \. ~\\'0. O~REMODE
o MULTI-FAMILY'\\ '-----'-0 AC RY BUILDING
# of Units: \~\~ -- ACHED GARAGE
o RESIDENTIAL (For 0 ATTACHED GARAGE
Additions, Remodels, Etec 0 DEMOliTION
\~
PROJECT INFORMAll0N:
(A ;<--t f
Plumber's Indiana State License #: "'-: "'-
Or 0 '? 'of .:~~
Which plumbing codes will be applied to the construction: .:fL. ~ ~_
c:::r1n'temational Residential Code w/Indiana Amend~ ~ "\P
o Unifonn Plumbing Code w/Indiana Amendments ~
(Multi-Family Construction COde)
FOUNDATION TYPE (Check all that apply for the new
Early Release <.-/' Manufactured :
P't Y N T r./ N construction area)
erml : russes:-...,.
- /~ / - 0 CRAWLSPACE 0 POST & BEAM
Lot Split:, _Y ~N ump Pump: ~Y _N c:v5LAB CY--BASEMENT
Does any part oft~~,proj)e ie within a special Flood designation area: '_Y ~ WALKOUT:_Y L/N
For Single F~~~~, and/or accessory structures, this pennit is valid only if construction commences
_ withinI80'~,~~~<mI~ffi.'If W~~~rmibl\lld must be c~mpJeted (Cettificate of Oc~upancy issued) within 18 m~uths of th~
Issuance date.; CI~1,.~t~~e~~~ . ~t.~q rM~i\hat~d.rmDlstranve R~es of the Stat~ of IndIana (See 675 lAC 12) regarding expIratIon
",', ," , ~,t~, e1tMes for beginnmg and completIng constructIon.
I, the undersign~,.IiCJ ~f~~'t:M:blfN.I:r'RP~~~OOSement, relocation, or alteration of a structure, or any change in the use of land or
structures reqt@t~GP G~p;,viij~Q, 'f\q~, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana -1993" (Z-289) and ~eiictnren'1s~atld d drlt1b~tE. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that' only ki~ Ad floor drains are connected to the sanitary sewer. I funher certify that the construction will not be
used or occu. until a Cercm ate' of Occupancy has been issued by th epartment of Community Services. Cannel, Indiana.
/ (- (. C~ 5~-/CJ -() 6
Sig P . Date
OFFICE USE ONLY: **************************************** ********~*'*~*******************
Filing Fees: :? / '-L 7...0
INSPECTIONS REQUIRED: ~
Base Inspections: ,.:;; 7;, ') 0 # Charged Re-
~per FO~ owe 'Footing Under Slab - <'3 ___() Reviews
Cert. of Occupancy: 2... ::s
~ P.R.I.F.: /:;2 (, /- () 0
TOTAL' 'c2
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,
Reviewed/Appr ed: Oepl. of Community Services
S:PermIts/Forms/ILP RESIDENTIAL
~
Additional Fees
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