HomeMy WebLinkAbout06070070 Application
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City ojCarmetf.f?lay Township Permit #: 0 feo 70070
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
et;qNE
al-CJ
0CITY
,0\'~\
FAX
31l-.:(j
SP
PROPERTY
OWNER:
. <'cn\
PHONE
3\1-\-
BEST METHOD OF CONTACT:
-c'\1\l ( \
SEWER UTILITY
PROVIDER: ~
WATER UTILITY
PROVIDER:
~
SQUARE I. r
FOOTAGE: LJ.:::) 7
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDlNG lAND VALUE) SJo,fX1J
LOCATION
&. PROJECT
INFO:
LOT #
ADDRESS OF CONSTRUCTION \
\~ QiVfu\'=\ QCf7
NAME OF UTILITY EXCAVATION CONTRACTOR; PlAN COMMISSION / W 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:
M MULTI-FAMIL~\
# of Units;~
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
if NEW STRUCTURE L'b ~tt'~\'\im \
o ROOM ADDI~~JTRUC'\'ll!J~r's Indiana State License #:
RE.OA~" If~" o'II'reGlllatiOns \0)1lJLl3
\fg. 'R r.,L n....'.> Whil 0. '"'
sub~t \ "O'~;Bll..lB/;l:I[~des.Which plumbing codes will be applied to the construction:
o @~!y S E R'stJ G&~ptional Residential Code W fIndiana Amendments
D~~M6N.ArefA'( TO'tiJ~\;IJrm Plumbing Code wfIndiana Amendments
C\ \lVr'Iol'N""iNOIANA (Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release
Permit:
Manufactured
_Y 1N Trusses: _Y V N
. /' 0 CRAWLSPACE
Lot Split: _Y ~ Sump Pump: _Y ~N CQ"SLAB
Does any part of the property lie within a special Flood designation area: _ Y V"'N
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o
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.
I, 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 will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 199r (Z~ 289) and amendments, adopted under authority of r.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
there . I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
use or CUPi~t;C~Of Occupancy has been issued:S:;\\~PC~:~k:uniry Services. Carmel, Indiana. (1141~ .
re of Owner or Authorized Agen Print Date
U5EONLY:************************************************************************
Filing Fees: /157. 00
INSPECTIONS REQUIRED: . (,000. CI '"
.....c:; S\ Base Inspections: __ v u
pper Footin Lower Footing ~nder Sla~ ~ ^' It! . 0 0
r--JI Cert.ofOccupancy: - -
~G0 50tJLl. 00
P.R.I.F.: 'f"..L
~ 1,3/5.00
/._; I/o Ar( ~/Z(. )0(,
# Charged Re-
Reviews
Additional Fees
TOTAL:
, (t>{"FeeReccl.II/LA, ~ 17-