HomeMy WebLinkAbout06070011 Application
City ofCarme//Clay Township Permit #: (Y;o'7co II
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, S. Two Family: New Structures, Additions, Remodels, S. Accessory Structures
BUILDER of
RECORD:
STREET ADDRESS
/I
40"""
BEST METHOD OF CONTACT:
L"'s.t~I!" h _ l
NAME PHONE FAX
TCl1H W.,' Kj
STREET ADDRESS CITY STATE ZIP
1'1'1 C,,~ ~
~'1 .J-
LOT # SUBDIVISION NAME SEmON
ADDRESS OF CONSTRUCTION -n /rp Sf ,;V SQUARE
/ CuI> I r '1/,a FOOTAGE: 43
WATER UTILITY
C PROVIDER:;, I
" <.-"'~
NAME OF UTILITY EXCAVATION CONTRACTOR; PUlN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
PROPERTY
OWNER:
LOCATION
s. PROJECT
INFO:
SEWER UTILITY
PROVIDER:
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o 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 ADDmON(S)
o PORCH ADDmON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
FAX
CITY
C "d' ""
STATE
:;::
ZIP
'-( i)
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING UlNO VALUE)-'- ..--.-.----..C..-C ,_..::::::-'
lr"-~\ 1',.71 I 0.-- \.::: .-: ;,-..,\ i
"I \\ l' '~j/,. ~ \i ' ~ Ii I';
i I U) (--c:.-"~~---1 \ II \i
PLUMBING CO~fnRjL - 6 2006 Il!JP
s..j"..(rl UI 1~_I.I".:>_, I
Plumber's India~ Sta e LIcense #: I
C~ LU4>-~S I
Which plumbing codes will be applied to the construction:
o International R!!sidential Code wI Indiana Amendments
'-.
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Manufactured
Trusses: _ Y x.@
o CRAWLSPACE
Lot Split: _ Y -<LN Sump Pump: -4- Y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _ Y LN
_Y...-X..N
o
~
POST & BEAM
BASEMENT
WALKOUT:_Y~N
For Single Family and Two Family 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 Indiana (See 675 lAC 12) regarding expiration
time frames for beginning and completing construction.
t, 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 \'.ill comply with, 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 ct scq, General Assembly of the State of Indiana. and aU Acts amendatory
thereto. I further ccrtify that only kitchen, bath, and floor drains arc connected to the sanitary scwer. I further certify that the construction will not be
used or occupied until a Certificate of Occu~has been issued by the Department of Community Services, Carmel, Indiana.
~~ P/Vt.vJ[ RG()Ao//Or2
Signature of Owner or Authorized Agent Print
OFFICE USE ONLY: ************, *,. ******************************
Subject to complrilllf!f9~~1l regulations lJI. ~O
PECTIONS RE UIRED: of State and Local Codes. . .:;2 71 SO
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Reviewed! Approved
S:Permits/Forms/ILP RESIDE f\
t.':'.)t-Ot..
Date
# Charged Re-
Reviews
Additional Fees
ices
(Oate)