HomeMy WebLinkAbout06070004 Application
City of Carmel/Clay Township Permit #Qb()7aoo'f
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
NAME
C -en rC
PHONE
mt:s
STREET ADDRESS
)
BUILDER'S EMAIL ADDRESS
BEST METHOD OF CONTACT:
PROPERTY
OWNER:
NAME
........!a.--l?':~~~-*;;;:~
FAX
, . ,.~t...."
STREET ADDRESS
CITY
STATE
ZIP
LOCATION
& PROJECT
INFO:
LOT # 41JJ
ADDRESS OF CONSTRUCTION
SUBDIVISION NAME
Ha.
SECTION 3
ZONING: 5 - :1-
SQUARE ,_
FOOTAGE: j 30 <&
SEWER UTILITY
PROVIDER:
399
r" TYPE OF CONSTRUCTION:::;' :
Jill SINGLE FA . (! . .:' .'
/0 TOWN E,;,; /
o TWO f'''''
# of
o MULTI, tt'lp:\,
# of Unih;\\ ..\
o RESIDENTIAL (For.
Additions, Re'models, Etc.)
\
PROJECT INFORMATION:
Early Release . . Manufactured FOUNDATION TYPE: (Check all that apply for the new
Permit: _Y L-N Trusses: Ly _N construction area)
o CRAWLSPACE 0 POST & BEAM
Lot Split: _ Y IN Sump Pump: -X- Y _N 0 SLAB ~ BASEMENT
Does any part of the property lie wi . Nood designation area: Y XN WALKOUT: Y N
For Single ~~t1A 11' 9.6'tfI' ' . .a"di!~~%e1s, and/or accessory structures, this permit is valid only if construction commences
within 180S'e~QCtlk'd1~A ~A'n.C~R ~6'deB\1g permit, and must be completed (Certincate of Occupancy issued) within 18 months of the
issuance date. Class I ~ta<<epl:F\'Wi6;\H1 s 'er.~~&l Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
i' f"\~ COMMUN\ i~~e~Tpf:~f.pningand completing construction.
I, the undersi~,Pa:greH~1;. aAY., ~trllc~~oif.GW~l11l~cment, relocation, or alteration of a structure, or any change in the use of land or
structures ref['!!~ ~'fh~'iUmr..~~ply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Cannel
Indiana -199"!",<~~>289) and amendtNID'~d under authority of LC. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. 1 further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
used r occupied until a Certificate of Occupanc has been issued by the Department of Community Services, Carmel, Indiana.
. . , rH !)AlJaJ f!ItVSfI/frJ
re of er or uthoriz Print
.,\\,
,~
,
./~ \:,.
':,/'TvP . PROVEMENT:
',,~ ,,\k RUCTURE
, 'oj 0 ~. OM DDITION(S)
'J q....--PORCH DITION(S)
~./O RE EL
0/ CCESSORY BUILDING
..d DETACHED GARAGE
//' 0 ATTACHED GARAGE
./ 0 DEMOLITION
Which plumbing codes will be applied to the construction:
~ International Residential Code w IIndiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
U d f)-Di.t
Date
OFFICE USE ONLY: **********************************************~****~~******************
Filing Fees: Z! tf 6Y
~CTI ~QU RED: Base Inspections: C) 7'7 :)' 0
Lower Footin~nd Slab <"'') .....-1\
, _ Cert, of Occupancy: J :/. J v
eterBase nal Si P,RJ,F.:.. / J ;,z'1I{)D-
7-5-0 ~~;f)4!J111- J'((j
ReviewedjAp roved: Dept. of Community Services (Date) ~
S:PermitsjFormsjllP RESIDENTIAL
# Charged Re-
ReViews
Additional Fees
~
Fee Received by: