HomeMy WebLinkAbout06060082 Application
City of Carmel/Clay Township ?~ Permit #: (j(;'oro Cb.ssa
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
ZIP
NAME
FAXgl/ h -t.J~ L
PROPERTY NAME
OWNER:
STREET ADDRESS
STATE
ZIP
LOCATION
& PROJECT
INFO:
LOT #
q
SUBDIVISION NAME
SECTION
ZONING:
ADDRESS OF CONSTRUCTION
SEWER UTILITY f\ ;(J I , 1
PROVIDER: l/ 11LW
NAME OF lJT1LTTY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I 8PW DOCKET
NUMBERS; TAC DATE{S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TYPE OF IMPROVEMENT:
% NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
{I.
PLUMBING CON ClOR.
:JEal\ C (rf[J.
Pluml'ier's Indiana ~~iC nse #:
llJ~
Which plumbing codes will be applied to the construction:
~ternational Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
on#oof units:
o MULTJ-FAMIL Y
.#.of Units;. .
o RESiDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit:
FOUNDATION TYPE: (Check all that apply for the new
construction area)
/' Manufactured /'
_Y ~N Trusses: '" Y N
/' /' 0 CRAWLSPACE 0 POST & BEAM
Lot Split: _Y ~N Sump Pump: V Y =N 0 SLAB rj. BASEMENT
Does any part of the property lie within a special Flood designation area: _ Y /N WALKOur:_ Y
For Si~... gle Fa ',. 'I e l::P.r~b-;; I' " s, and/or accessory structures, t~~' rf&bi~~yfif ~ti1i~ti~~
with~n 180 d~~"t tQ~Qf7P1Qti~l.~~tvrHl!l:O cfliri~~d must be completed (CertificH1 (] ~~ '...: y-~tht;'-:I&, ~nt
issuanc,e date. C.lass I st~., ,. &tatgtat'iiti>h.ocs4lh~O.8be General Administrative Rules of the St' diana (See 675 lAC 12) rega ng
rn:pT 1"11= ~OMMIINIl"r'SERV~.nningandCOmpletingConstru .
t. the unders~~.e;; e 'I!ti~ ~l?.Y.io.n~trucri5WI' rl\lJ.ns~~1 [I em, relocation, or alteration ~ tureJU ~y ~h~gqo~ us I .or
structures req\W*:d"~~Vi:mb41 u~~tkI 0, all applIcable laws of the Sra f I iana, and the "Zomng Ordin armel
Indiana - 1993~ (Z~ 289) and amendnrNlf)MVAi under authority of LC'. 36~7 ex scq, General Assembl t State of Indiana' menda ory
thereto. I further certify that only kitcfien:bai:h~ and floor drains are connected to the sanitary sewer. I unher certify that the construction will ot be
used occupied until; ert' icate of Occupancy has been issued by the Department of Communi y Services, C<-\rmel, Indiana.
.-' (\ ,,0
'Of) (\., 11'(DLLJ
Print 'v
N
Date
NLY: ******************************************~*******~~****************
Filing Fees: <JCa7. "?5U
INSPECTIONS REQUIRED: ~ rJ r:J r-O Ch d
~ Base Inspections: ...". -I- ' ~_ # arge Re-
~r Footing Lower Footing. 11 nder Slab ,;::-3 . "-0 Reviews
- . ~ - Cert. of Occupancy: .;..J...' -.:> '
~~al S~ P.R.I.F.: j:zter.()O
''5
c.\"a....:~ H1so-r .. 1O~13--r.i>
Reviewed/App oved: Dept. ofCommumty Services (Date)
S:Permits/FormsjILP RESIDENTIAL
Additional Fees
Fee