HomeMy WebLinkAbout06060052 Application
City of Carmel/Clay Township cY';;ermit #: ~vOlt 01l{J.
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
CITY
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BUILDER of
RECORD:
NAME
~.,D~
STREET ADDRESS
PROPERTY
OWNER:
H
LOCATION
& PROJECT
INFO:
LOT #
:5):
ADDRESS OF CONSTRUCTION
SEWER UTILITY
PROVIDER:
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
TY~MPR6VEMENT:
NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
F N R CTION:
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit:
03
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BEST METHOD OF CONTAIT:
_~J~)
'31 $ '2-13)
FAX
PHONE
SECTION
ZONING:
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li[\\1 JUN - 7 2006 II
~
PLUMBING CON~f . , _ S
A,(2, ')1>>-( l. ,,} C.
Plumbe'r's IndIana State License #:
C f 5?J'Ci DO Cl~ t:)
Which plumbing codes will be applied to the construction:
o International Residential Code wI Indiana Amendments
~nn Plumbing Code w/lndiana Amendments
(Multi-Family Construction Code)
Manufactured v: FOUNDATION TYPE: (Check all that apply for the new
_ / construction area)
_Y JL....N Trusses: y, N
o CRAWLSPACE
Lot Split: _Y I/'N Sump Pump: II" Y 'N 0 SLAB
Does any part of the property lie within a special Flood designation area: _ Y VN
o PO.>r & BEAM ~
~SEMENT
WALKOUT:_Y_N
r For siIlE~emo-FOf'itrCG.~iJiAOO....J(I)pJ'emodcls, and/or accessory structures, this permit is valid only if consuuction commences
, withSut!1Jelet'tlSrc6fti\3m.trfetf'*fflf iflt~lll'~rmit, and must be completed (Certificate of Occupancy issued) within 18 months of the
. )issuance date. Cerstttfflca)l,r8 termlfrerie aU c '~~~eneral.Ad.ministrative Ru~es of the Stat~ of Indiana (See 675 lAC 12) regarding expiration
.. oca 0 IS me frames for begmnmg and completmg construction.
I, the u~e'PijrGmMM'.1'NJiJiit~fiSERMJ@.ESn, enlargemem, relocation, or alteration of a structure, or any change in the use of land or
strucreA'1"Ytl.B'F~A.1IbiJi "miicltp} ~ij,c~\'j. 'tiJi~ L\9~nform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana':' 19'93"l.Z- 2'!f~)'1\<1Mrirndm~"r!,1tlopt'ed t't;mH.L~MTIity of LC. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify thal~bAtNA, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
used or occupied until a Certific te of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
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Print
P.R.I.F.:
l~
Reviewed/Appro d: Dept. of Community Services
S:Permits/FormsjllP RESIOENTIAl
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Date r I .
Additional Fees
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