HomeMy WebLinkAbout06060199 Application
City of Carmel/Clay Township Permit#: Q&'Oc::>otqj;
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory St~uctures
BUILDER of NAME
RECORD: 6 'd
STREET ADDRESS
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BUILDER'S EMAIL ADDRESS
PROPERTY NAME
OWNER: .. ; ~ '"
STREET ADDRESS
'lke.
SUBDIVISION NAME
LOCATION
& PROJECT
INFO:
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LOT #
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~~CL
~. .ADDRESSOF CONSTRUCTION
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Cc...
SEWER UTILITY
PROVIDER: (;qr~\
Co.~
NAME OF UTILITY EXCAVATlONC;Of\!TRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR~COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o -TWO FAMILY.
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
,Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
r?f NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
PROJECT INFORMATION:
Early Release
Permit:
PHONE
FAX
\..
CITY
STATE
ZIP
\
BEST METHOD OF CONTACT:
..
PHONE
FAX
CITY
STATE
ZIP
c.o.
~
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SECTlON
ZONING:
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~
SQUARE 1I>!>8'l"
FOOTAGE:
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
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PLUMBING CO~ RACTOR:
In,1 JUN 272006
Plumber's In i~n State License #"
. ... 5~
Which plumbing c es-witt'be" pp led to the construction:
~ International Residential Code w/Indiana Amendments
o Uniform Plumbing Code wjlndiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Manufactured
_ Y LN Trusses: L Y _N
o CRAWLSPACE 0 POST & BEAM
Lot Split: _Y LN Sump Pump: -"-- Y _N 0 SLAB- ~BASEMENT
Does any part of the property lie within a special Flood designation area: _ Y ~ WALKOUT:_ Y LN
For Single ~maS~~~allJlGTrlG.N-els, and/or accessory structures, this permit is valid only if construction commencd,
. within 18~~9Ct~ptl~tf~fI1ttthPtWffl~~ti and must be completed (Certificate of Occupancy issued) within 18 months of the
Issuance date. Class I 8f1S1tHe 1Efi1~t;a6arvl;Jj(s;&.w:tlieGene:~:al.Ad.ministrative R~~es of the Stat~ of Indiana (See 675 lAC 12) regarding expiration
'1wtt'c"'tfames for begmnmg and completIng constructlon. l
I, the undersi~~QlfiaC.qMMUN:bIYeSEliU.(dGSSargemcnt, relocation, or alteration of a structure, or any change in the use of land Q~
structures rGPWOPJmAr:JR~'I!: f-~~~\1AU\~n to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmd
Indiana -1993" (Z~289) and amen s 0 tea uhcrer'"Ju'tt~lty.M r.c 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certif' t only ~iA A, and floor drainsare connected to the sanitary sewer. I further certify that the construction will not be
use occupied un a njFi ce of Occupancy has been issued by the Department of Community Services, Carmel, Indiana. "
OFFICEUSEONLY:************************************************************************
INSPECTIONS RE UIRED: Filing Fees: /0 f 7 . 70 :
O ~ .. Base Inspections: -) 7'1 <) 0 # Charged Re-
Upper Foo . Lower Footin Under Slab z:.,.. -J\ Reviews
. Cert. of Occupancy: L.c;- 3. S---U
/""'"ROugh In ....l-J.1eter 8a""~ Fi ~ Site -...., J I ()
'- ~- ~\..-.::;?' ~ / P'R~H.~ TOTAL;::i(, ~d 1. 7~dditionalFees
C<tL:~ 111~J' 6-N~6b
ReviewedjAppr ved: Dept. of Commumty ServIces (Date)
S:Permits/FormS/ILP RESIDENTIAL Fee eceived by:
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Print
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Date