HomeMy WebLinkAbout06050209 Application
City of Carmel/ Clay Township tY -~~ Permit #: f) ~ 0 ~() ZtfJ
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, 8< Two Family: New Structures, Additions, Remodels, 8< Accessory Structures
BUILDER of
RECORD:
FAA
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~
BEST METHOD OF CONTACT:
(Y)
PROPERTY
OWNER:
PHONE
<6~-::2 --C\'S I
FAA
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ZIP
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ESTIMATED COST OF CONSTRU~
(EXCLUDING LAND VALUE) r~u
LOCATION
8< PROJECT
INFO:
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET ''''('
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL ANa/OR SEPTIC PERMIT #'S (IF APPLlCABL ): \bE if
TYPE OF CONSTRUCTION: ~ TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR: ~f1e...\ -~'cifr,,},.$'
o SINGLEFAMILY ~?;Jj NEW STRUCTURE ~ ...B~"".I.l
~ TOWN HOME Il-<v.. 0 ROOM ADDITION(S) Plumbe 's Indiana State 'cense #: -,.
o TWO FAMILY 'J~ 0 PORCH ADDITION(S) 5 D -
# of Units: 0 REMODEL
o MULTI-FAMILY 0 ACCESSORY BUILDING Which p'umb~'i<>jle 11~'PPlied to the construction:
# of Units: 0 DETACHBmD tea ~~t,rn~Jlai~1i.!'COii!!;wtln!liana.Amend/!lents
o RESIDENTIAL (For 0 ATTACH - I~ith all regu"l'i \ I IJ:=: (( ;; IS; n \\ f1 fc~ ~~
Additions, Remodels, Etc.) 0 DEMOLI '..19. C car1'\p no ~re8!!;U~il1l!. 'Id w/Inili."'!~!,!~~~ r-\\!
0\ State :Li~ . Code) ! I I: i
PROJECT INFORMATION: . . . OF CO MUNI'(;:) , II i i/
ClS,Pi U . hMA)l1I that aDDlv-for the ri~w
Early Release \/_ Manufactured ~ OF CAR r n area) U Ii J' T cwo iii'! Ii
Permit: _Y~N Trusses: tr' I",n\ '/1. 1 u IlL /'1
'-11 - '1::1 RAWLSPA~-pe5+-&.BEAM_JL:::./1
Lot Split: _Y ~N Sump Pump: Y _N 1jl SLAB . 0 BASEMENT I
Does any part of the property lie within a special Flood designation area: _ Y N 6lffi- Y~f11
For Single Family and Two FamHy dwellings. additions, remodels, and/or accessory structures, this permit is valid only if construction commences
within 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits are subject to the General Administrative Rules of the State of lndiana (See 675 lAC 12) regarding expiration
time frames for beginning and completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or
structures requested by this application will comply vvith, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993" (Z~ 289) and amendments, adopted under authority of l.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
us occupied uutil a Certificate;foccupancyhas beeu is~ued ~y tD~mc~rf~l\ices, Catmel, Indiana. ~
Signature of Owner or Authorized Agent Print Date
**************
OFFICE USE ONLY: ********************************************
Filing Fees:
Base Inspections:
Cert. of Occupancy:
~ECTIONS REQUIR
~g Lower Footing
~~ Final
.xJJj/
# Charged Re-
Reviews
P.R.I.F.:
Additional Fees
tL/,{JR.
Reviewed/Approved: Dept. of Community Services (Date)
S:PermitsjFormsjILP RESIDENTIAL