HomeMy WebLinkAbout06060210 Application
City of Carmel/Clay Township vJ-Co~ Permit #:~()(.gO dZ-.ID
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of NA~f1
RECORD:
STREET ADDRESS
PROPERTY
OWNER:
NAME
>fr<'r..e
STREET ADDRESS
LOCATION
& PROJECT
INFO:
LOT #
IE
SEWER UTILITY
PROVIDER: C-ML M c L
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PHONE
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ZIP
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WATER UTILITY
PROVIDER: CAP-ME L
CITY, . '""
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BEST METHOD OF CONTACT:
P ()M
PHONE
FAX
CITY
STATE
ZIP
SECTION
ZONING:
P...;D
SQUARE 2Q II
FOOTAGE: I ~ /
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) 100 00 0
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET W II-I.. S e )( CAli A-TI N (,.
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
Manufactured
_Y AN Trusses: ~Y _N
o CRAWLSPACE 0 POST & BEAM
Lot Split: _Y ~N Sump Pump: _Y -2:'::...N ~SLAB 0 BASEMENT
Does any part of the rmJ ~~tilf;.yJ~t!) cial Flood designation area: Y N WALKOUT: Y N
For Single Family and Two Famil)(j:J,~R~!I~tFfmo ,C11t(iJNcessory structures, this permit is valid only if construction commences
within 180 days of the ~l}1\a~~e~~tc8Pi.petm!tI;e.9diRllYB.bi completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I re e:mffi:di~l1fI ,t.o':l'H~ 9Q(4;S.Admim~'tlativc Rules of the State of Indiana (See 675 lAC 12) regarding expiration
F CA r..., =- ~ _".{i<<t\='mh1eyr~ ~rni,gg:nd completing construction.
I, the undersigned, agre at any construg'MUilcghf!):J.H:;iji{'}14rga~~ 3location, or alteration of a structure, or any change in the use of land or
structu equested by s application will1#INJir A"itp~d ctl~WM_,QlJjlAAlicable Jaws of the State of Indiana, and the "Zoning Ordinance of Carmel
In. a - 9r (Z~289 nd amendments, adopt[cf~VAuthority of I.t". 'nf"tie'tseq, General Assembly of the State of Indiana, and all Acts amendatory
ereto. further certi t t only kitchen, bath, and floor drains are connected to the sanitary Sewer. I further certify that the construction will n t be
used occupi~ u I Certi!icatt: of Occupancy has been issued by the Department of !=ommunity Services, Carmel, Indiana.
'R~A10 'K-Pf/V{
re of OWne or Print
OFFICEUSEONLY:*********************************************J*********~****************
Filing Fees: ta.9i3 , ) u
ONS RE Base Inspections: ').. ~7 ,. sO # Charged Re-
lab . ReViews
Cert, of Occupancy: S3 . .!;;'[)
II1rr~~'d ~...-
j :~:A~ ~~ {l'L~~\ ~~aI~
Fee Received ~ ~ ; I t-t 1 ow
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
~ TOWN HOME
o TWO FAMILY
# of units;
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit:
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
inal
P,R,I.F,:
(Date)
Reviewed/Approved: Dept. of Community Service
S:PermitsjFormS/lLP RESIDENTIAL
PLUMBING CONTRACTOR:
?AvL 13 S'/VllTl--i
Plumber's Indiana State License #:
c..p 81 b I 1--1--+ ,
Which plumbing codes will be applied to the construction: