HomeMy WebLinkAbout06060239 Application
City of Carmel/Clay Township Permit #O(d)foO:Z~F1
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &; Two Family: New Structures, Additions, Remodels, &; Accessory Structures
STRE
BUILDER of
RECORD:
PROPERTY
OWNER:
NAME
PHONE
FAX
STREET ADDRESS
CITY
STATE
ZIP
/1
SEWER lJTlLITY
PROVIOER:
LOT # $. c?
ADDRESS OF CQNSTRurnON 115 t/ ()
WATER UTILITY
PROVIDER:
ZONING:
/
/'
LOCATION
&; PROJECT
INFO:
SQUARE
FOOTAGE: 0 Jt7
1.&17 j{PO
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW D CKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
~
o
o
o
o
o
o
NEW STRUCTURE
ROOM ADDITION(S)
PORCH ADDITION(S)
REMODEL
ACCESSORY BUILDING
DETACHED GARAGE
ATTACHED GARAGE
DEMOLITION
PLUMBING C NTRACTOR:
S\G t-.1l1;\\An:. - ~\~
Plumber's1ndiana Stat~se #:
~qDoa
TYPE OF CONSTRUCTION:
Iii SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
Which plumbing codes will be applied to the construction:
~nternational Residential Code wI Indiana Amendments
o Uniform Plumbing Code wjlndiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release / Manufactured FOUNDATION TYPE: (Check all that apply for the new
. ./ construction area)
Permit: _Y _N Trusses: _Y ~N
. 0 CRAWLSPACE 9 POST & BEAM
Lot Split: _Y V N Sump Pump: VY _N 0 SLAB ./ f;J. BASEMENT
Does any part of the property lie within a special Flood designation area: _ Y LN WALKOUT: Y_N
For Smgle Fan!llE41eA&IfG>~OONIiiITtBb.lG,hlQN. andlor accessory srrua:url'k~\h,ts.l'..~V~1f."UJ!S!rUction commences
Wl~hm 180 d~tttJi~qtf'(ftfrVl"Pl:PS~ wn~l!!141~k>rl8d must be comp1eteft ~. r@~atf:?tct~~B~ncY}SSli~_~)jWi1;~I~ 18 months of the
Issuance date Class1 st"Q(fSful(erllVf8 '\':offil:lit:b~e!jc General Admmlstratlve RUlI~ pf,' .Stattof-Inatana'<S=6751t}U' l41, regardmg expIntion
tIme r~~? fp..h.~~nnmg and coroplet! ~lc6 rructIon I I I 11
I, the underslgnJa,IiJ?ct" tQFarC;GrM~H~n .m.m.M-J,~~ement, relocanon, or ~,,~ on of j1li~I;Uctur$, or')?rn:'fhang, 1m t~f use of land or
structures reqtpfW~ ~F.tMEt.~ p. ,N~ all applIcable la\ ' StaM t11f'fnd~mW, aEWllit: "Z9~If1gI0rdmance of Carmel
Indiana -1993"~-':2~9) and amendments aCla e r aut ~orrt",,36-7 et seq, Gene I A mbly of the State of lndiana, and all'Acts amendatory
thereto I further certIfy that only kitUWJ:)iA: d floor drams are e neeted to the samdry se' l.u:JJu:r...c.e.niiYJ.h~uhe16nstrJctlOn Wlll not be
used or occupIed unnl a tihe e [Gee ancyhas been Issued b he Department t(:o mumty ServIces, Carmel, Indiana 1
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Oate
Filing Fees:
Base Inspections:
Cert. of Occupancy:
__Fin~.I.F.: (cI-. hi, dO Additional Fees
-. .. ~/ ~TA:/7. /~t;F3o
{JS- <---/: ~~~~ .
ReviewedjAp oved: Dept. of Community Services (Date)
Fee "L -'""ved bv..
S:Permits/Forms/lLP RESIDENTIAL ~~IVt
# Charged Re'
Reviews
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