HomeMy WebLinkAbout06060086 Application
Tity-ofCarmel/Clay Township Permit #: IJ~ 0 (p, OO~b
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of ~E PHONE FAX
RECORD: Itll '(... C-il(..6L- CA~""GL FIll.[ par. 571- 2.(,(J h S7/-2.(,I.r-
STREET ADDRESS CITY STATE ZIP
L C .\/i C- J: v...~e C"'.....""" I /1\/ 'f60.) L
BUILDER'S EMAIL ADDRESS
1'1c. CA'4"Iel.;..,. ov
LOCATION
&. PROJECT
INFO:
NAME PHONE FAX
.TI!Y 6-eHL .3;-74- 0 77
STREET ADDRESS {IIQffi'l CITY STATE ZIP
~r~ i., 'i '" er- e /lrI({ I.v 'jc"O,j'L
LOT # SUBDIVISION NAME SEmON ZONING:
20 fJ{2..lr/ C- fJ..l/N e.f1'. -f tJ'i
PROPERTY
OWNER:
ADDRESS OF CONSTRUCTION
10 (;No/.t?d J';-,dt {...",,,e
SQUARE / 2-"/
FOOTAGE: Ie> ,.
SEWER UTILITY
PROVIDER:
WATER UTILITY
PROVIDER:
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
N COMMISSION / BZA / BPW DOCKET
lOR SEPTIC PERMIT #'5 (IF APPLICABLE):
PLUMBING CONTRACTOR:
o
NEW STRUCTURE
ROOM ADDITJON(S)
PORCH ADDITION(S)
REMODEL
ACCESSORY BUILDING
DETACHED GARAGE
ATTACHED GARAGE
DEMOUTION
Plumber's Indiana State License #:
o
Which plumbing codes will be applied to the construction:
o International Residential Code w /Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
Manufactured
_Y _N Trusses: _Y _N
o CRAWLSPACE
Lot Split: _Y _N Sump Pump: _Y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _Y_N
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Early Release
Permit:
o POST & BEAM
o BASEMENT
WALKOUT:_Y_N
For Single Family and Two Family dwelli~~adc!i..t~8f r~~llnd/or accessory structures, this permit is valid only if construction commences
within 180 daY.'ioQ~l:t~~f:&~)~N.tJtllrfg~.:Wm~~J1must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. CI~~~uredtr~ffirl1eA"W~ glltt'e~kl\i;QI).!8.ministrativc Rules of the State of Indiana (See 675 lAC 12) regarding expiration
Subject to . Oem<c~sfor beginning and completing construction.
I, the undersigned, agree thaaf~t~~tRIt8~~i~1.q;~.Q.s.rrp.ce.'~' \1lP_~ent, relocation, or alteration of a structure, or any change in the use of land or
structures reQueste!fJ,MaeJf1t;@@ MMQlI1p1yM!{t~ b~~~~hiw~ applicable la\vs of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana -1993~ (Z- 'Incl a tote 1iJif1)W~1t;ti~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further G4t tQ~:~~~t~~r drains are connected to the sanitary sewer. I further certify that the construction will not be
used or occupied until a Certi' e o~~~~'bccn issued by the Department of Community Services, Carmel, Indiana.
~-
Signature of Owner or Authorized Agent
f'-'fl;f.l<' (;. C-,/,;..(;/-.
51i(,/(J~
Print
Date
OFFICEUSEONLY:************************************************************************
Filing Fees: ~
INSPECTIONS REQUIRED: .Il r.... .
Base Inspections: A Q) \. A _n 1\ ~ # Charged Re-
Upper Footing Lower Footing Under Slab \ I) tJ -r:: j()I/" ReViews
Cert. of Occupancy: --\ _ ~ CI~
Rough In Meter Base ~ I "'-\' \ -' ~
c.::,,',:-::/ P.R.LF.: l,Gr ttl 0 Ad ional Fees
TOTAL: Df~'
. ~17) ,J/r;.&di,
Fee Rec. by ~ l{ {J;(fS( oCt
b-14-i:J.(,
Reviewed/Appro d: Dept. of Community Services (Date)
S:Permits/FormsjILP RESIDENTIAL
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