HomeMy WebLinkAbout06070081 Application
City of Carmel/Clay Township Permit #: o(qo70Q <2:, I
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
BUILDER'S EMAIL ADDRESS
@\:)
PROPERTY
OWNER:
NAME
STREET ADDRESS
LOCATION
& PROJECT
INFO:
SEWER UTIlITY WATER UTILITY
PROVlDER=c: PROVIDER: C
NAME OF UTI EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE);
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MUL Tl-FAMIL Y
/' # of Units:
51 RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
~OOM ADDmON(S)
DORCH AD.pI];ON(S)
-RFMODEL~
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
cm
STATE
ZIP
a ~
I
BEST METHOD OF CONTACT:
PHONE
FAX
-73i~
STATE
ZIP
~
SECTION
ZONING:
s-
SQUARE
FOOTAGE:
- .,-.-----.-...-.- ---._~
\ \ r-. _:~ (C~ [~: n '\,? j :.:::, fi.~~>\ 1
o International Residential Code wI Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release / Manufactured / FOUNDATION TYPE:
Permit: Y v N Trusses: Y _N construction area)
. - - / / 0 CRAWLSPACE
Lot Split: _ Y ~N Sump Pump: --L Y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _Y LN
(Check all that apply for the new
g / POST & BEAM
(}'f BASEMENT /"
WALKOUT:_Y~N
For Single Family and Ta~~rij()aIGQN&IJIU:lIC.1"dGN::cessory structures, this permit is valid only if construction commences
within 180 days of the $9bjr9mit~P1~iwtnn:BW't~QPat1!5r\s completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structure peraPSftf&~~'ff c~f ~rrs.~d.ministrative Ru~es of the Stat: of Indiana (See 675 lAC 12) regarding expiration
~ r..a~ 1~~'1)~~l}I~AIl'I completmg construction.
I, the undersigned. agree tQE~loQI?u~QNt :ft..l.htioo, ~e.IgeVrl~cation, or alteration of a structure, or any change in the use of land or
structures requested by ~WiA~~~' \Y!~~rJf~p'ln:i:tablc laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - I99r (Z~ 289) and amendments: adop e thority 'Of r.t~ ~t:1 e~leq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen,'bat~ ~ins an: connected to the sanitary sewer. I further certify that the construction will not be
us d or occupied until a Certificate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
a.
LOR; A. B;R~soNG-HE~.II;Al(
Print
7/1" )01.,
Date
OFFICE USE ONLY: ** ********************************************'**~*****r***************
Filing Fees: / "3 3 -;,C
INSPECTIONS REQUIRED: 'III () 'J Ch .
Base Inspections: _ --.: '- # arged Re-
Upper Footing Lower FODting Under Slab . . ) Reviews
Cert. of Occupancy: ::> 3. )' C
0~U9h 10 Meter Base ~ Site
~ P.R.I.F.:
c
Additional Fees
~/ToiAL: ;ii}fP dO
/ //'_. /- ,I 1/
".:; ,(/ rL//I /f/'/I.6~./'
Fee Recei6ed by: L--" .......
?-JQ-c6
(Date)