HomeMy WebLinkAbout06060118 Application
City ofCarmellClay Township ~ermit #: OCoO~ 01/8
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
SEWER lITlLITY
PROVIDER:
BUILDER'S EMAIL ADDRESS
FAX
ZIP
'/
BEST METHOD OF CONTACT:
FAX
ZIP
~~
-\
.z..
.L/()
NAME OF lmLITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
TYPE OF CONSTRUCTION:
~E FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release / Manufactured . /
Permit: _Y _~/ Trusses: Vy. N
./ ~ 0 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 ~
TYPE OF IMPROVEMENT:
eY"'NEw STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
PLU;iIN CON~OR:
u,J ~ (;( b
Plu~.niiiana State License #:
i /0777 )
Which plumbing codes will be applied to the construction:
lJ1'International Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments I
(Multi-Family Construction Code)
,
I
(Check all that apply for the new
FOUNDATION TYPE:
construction area)
o POST & BEAM
ca- BASEMENT
WALKOUT:_Y ~
For Single Family and Two Family dwellings, add~~~~1.i. ~~a~~l'1~~1[}l~i..fbi&. Dermit is valid only if construction commences
within 180 days of the date of issuance of the buircl~Ht);i~1JI tMJ1'''tl~~,"ildQN"f Occupancy issued) within 18 months of the
issuance date. Class I structure permits are subjectS~~ec;t~~p)ilt~Wi~ MQwlifttonSlndiana (See 675 lAC 12) regarding expiration
time frames f~I>9li!lll!'1llrttl<L~lee~li'S'?stmetion.
I, the undersigned, agree that any construction, reCO . r . r. ructure, or any change in the use of land or
structures requested by this application \\ill comply J2m~Jt~6f&!~U~\ ~\9~~~ Indiana, and the ~Zoning Ordinance of Carmel
Indiana - 1993" (2- 289) and amendments, adopted GRrYuC!Jli'itOARMBst{s@l9lt{r1f<9Wf\l1S1:tlIlpState of Indiana. and all Acts amendatory
thereto I further certify that only kitchen, bath, and floor drains are connGGttf4PiQ.l1 !jtlnitary se\\>er. "ilurther certify that the construction will not be
used occupied until a T{ificateofOccupancyhas been issued by tR~WI"iHm~mmunity s;rvices, Ca<mcl,lndiana. 1/ )1f>1(JG"
Signature of Date I I
OFFICE USE ONLY: *********************************************~7**~********************
Filing Fees: M ' ;)0
INSPECTIO 5 ED: '?Jr) ~J)
Base Inspections: ~~.&. -' (L
Lower Footin nder Slab 5-3_ <0
Cert, of Occupancy: _ 0 L
tl S~ P,R,I.F,: 12(,/ Oi) Additional Fees
! TOTAL: ;fI ~77-J .;(0
'-----p ~~1'~
Fee Received by: '
Rough In
CIN< ,,-~ /p~ (.,.~q~t2{,
Reviewed/App ved: Dept. of Community Services (Date)
S;Pefmits!FOfms/ILP RESIDENTIAL
# Charged Re-
Reviews