HomeMy WebLinkAbout06070180 Application
City of Carmel/Clay Township Permit #Ofon7 0 115()
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
PHONE
FAX
675 ;;(3/
()3Q
PROPERTY
OWNER:
STREET ADDRESS
CITY
LOCATION
&. PROJECT
INFO:
LOT #
30
a SUBDIVISION N,AJ1E
SECTION
/
SEWER
PROVID
NAME OF UTI CAV N CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNn WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
F ON RUcnON:
INGLE FAMILY
TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
,..EJl-NEW STRUCTURE
'0 ROOM ADDIT10N(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING Which plumbing codes will be applied to the construction:
o DETACHED GARAGE~, ~ternational Residential Code w Ilndiana Amendments
o ATTACHED GARA' -. U'f PI b' C d II d. A d ts
o EMOLITION ~ m orm urn m9 0 e w n lana men men
D (Multi-Family Construction Code)
P'l:lBING CONTRACTOR: -;-
~cI C)mo "L;,/
plumber's Indiana State License #:
(' P IrKrY)/{) /
PROJECT INFORMATION:
Early Release /"\ Manufactured ~
Permit: _Y ----Lf>V Trusses: --0-N
~ .IV'\ 0 CRAWLSPACE 0 POST & BEA
Lot Split: _Y Sump Pump: ~N 0 S ~SEMENT M
Does anwmt.ta!'"~rfi , Q~ili~Y Tip flood designation area: WALKOUT: Y
For Singl~l!9 an~ 9~9 m1.UN~J~lD~ions, remodels, and/or accessory structures, this permit is valid only if construction commences
within 180 days oA:h~mi ~.i~Ran...9i#li~it, and must be completed (Certificate of Occupancy issued) v.rithin 18 months of the
issuance d~fUfs(I)ftt~~t,Siate 1u e t to t.h.~enfSal Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
nr= rARMEL I CLAYt W~lO\Ibeginningandcompletingconstruction.
I, the undCl~ct;-a~reYth'at aqy rtP\l~1ft1p..Gtjpn, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land Of
structures requested by this applit':H~~l.-i!f'Cbmply 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 LC.16-7 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 Se\VCT. I further certify that the construction will not be
use occupied until a ertificate of Occupancy has been issu the Department of ommunity Services, Car~d, Indiana.
FOUNDATION TYPE:
construction area)
7~~/CJG
Date
OFFICE USE ONLY: **************** *** ****** *** ********* *** ******?7...*rf**** ****************
Filing Fees: Q G. ;7 Cl
INSPECTIONS REQUIRED: ,::7. -7' "7, ,';-f) # Charged Re-
.~ ~ J Base Inspections: '-./ ,<-
URl!.er Foo.!iPlr er Footiii U r, Slab ''jtf .- " Reviews
Cert. of Occupancy: -' -'- .J I.-
Site
. .J ~I /"',
P.R.I.F.. /,~ b, I ,( ,
\ ~') 1"'2;;0
'-~' _/ TOTAL: / /5 " -,
/ 7'//. ~'l "
t ~ cc?D' ~A '--T
r _,
Additional Fees
.--. /?
I~
ReviewedjAppr ved: 'ept. of Community Services (Date)
S:Permit5/Forms/ILP RESIDENTIAL
Fee Received by: