HomeMy WebLinkAbout06060088 Application
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CuyoFCarmel/Clay Township Permit #: f)ra042(JO~o
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, 8. Two Family: New Structures, Additions, Remodels, 8. Accessory Structures
FOUNDA nON TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST &.BEAM\
Lot Split: _ Y _N Sump Pump: _ Y _N 1i'C SLAB D-BA'sEMENT \
Does any part of the property lie within a s ecial Flood designatiorlarea: _Y.-:-Plf-- WALKOUT:' ~ n~-----kN
-- ---- ", ,\,
For Single Family "8' \);9.f.wi. dw. 1m' l!. ~.. O/;llt ftit\\ffiill..;w;!/or accessory structur.i." this II"rmifis;;;;]id only if COll.stru~U9rl,.~bm. mences
within ISO, days oMH l8h.!' 6ri&sl HI~e lQ.lj- "e bm 1~&~rii'lIt, and~'rtst be completed (Certificate-oT Occ~.g'N1~y.:ipsfted\14\\hin 18 months of the
issuance date. Class I structUlQf~it\P.. if'tt-S . {1 M\{e'~~f1eral Administrative Rules of the s~~~fl;{'Indi~ce.67~ L~C 12) reg.h-~~~g',~xpiration
DEPT OF COMMUNrJiVnSH$il\ld~andcompletingconstnld,tio~\\ /.J\\\\\ I
I, the undersigned'~~EYr'WBw.H~ln, ,e~s ~'f:...u~prelocation, or alteration 6\f, ~ s4vf[Ure, or any.s.ha~ge W$1~<ys~'Joflani:(9r
structures requeste~ItHis'Tpli~h~~J;l ~~ addYoMdrm'1:b,"an applicable laws of the Sta\; of. IpqLa~_.a{al}d~i:h~i."Z.6~~rig.oi;..clirianceof Carmel
Indiana -1993" (Z~289) and amendments,~ r authority of r.c. 36~7 et seq, General Assembly pf~h~\St~;~ f1f/!nqian..e~and.alrActs amendatory
thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further~cer~ifi"thatihe construction will not be
used or occupied until a C,-tificate of Occupancy has been iss~~..by ~e DeP.:':tmem of SOJ'munitY\S~~iCe-;, Catmel, Indiana. I
(~kfr- ~ ' !f)P0 &r,t '3> b (b !r)(.
'iignature of Owner or Authorized Agent Print ' Date r
\
~ICEUSEONLY:*********************~******************************~J\*****************
\ \ Filing Fees: L33, 6u
INSPECTIONS REQUIRED: .,rAr '0
l'\ Base Inspections: ,~ ~ # Charged Re-
er Footing Lower Footing Under Slab ~ .~ . ReViews
\ -- -=) ~ t Cert. of Occupancy:
"\ In Meter Base ~~~~ i(D P.R.I.F.: Additional Fees
\\ ~// ... !~OTA~L:'/7 .4i Ii,. 0 ()
, -/4-O{ ~~~
ept. of Community Services (Date)
,;DENTIAL Fee Received by:
BUILDER of
RECORD:
PROPERTY
OWNER:
STREET ADDRESS
~/' J-t- C
LOCATION
8. PROJECT
INFO:
LOT #
SUBDIVISION NAME
SEWER UTILITY
PROVIDER:
ADDRESS OF CONSTRUcnON
I.:?- '/
~Y"h-<-u(
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
o NEW STRUaURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
'fZL DEMOLITION
PROJECT INFORMATION:
Early Release
Permit:
Manufactured
Trusses:
_Y_N
_Y_N
SEcnON
ZONING:
SQUARE
FOOTAGE: 126
ESTIMATED COST OF CONSTRUcnON:
(EXCLUDING LAND VALUE) ~ VO
o
~t~
o International Residential Code wI Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments I
(Multi-Family Construction Code)
Which plumbing codes will be applied to the construction: