HomeMy WebLinkAbout06080063 Application
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\\City of Carmel! Clay Township Permit #: (tog Ofl€ 3-
.KESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
lOT #: ')-{p SUBDIVISION NAME:
ADDRESS OF CONSTRUCTION: \3
WATER UTIlllY
PROVIDER:
NAME:
,.jUILDER
Of
RECORD:
PROPERTY
OWNER:
NAME:
STREET ADDRESS:
LOCATION
&. PROJECT
INfO:
SEWER UTIlllY
PROVIDER:
t.1tw
FAX:
fiI
S;' ZIP:
'ZONIN5;:
'SQUARE J I '\ C2..CI.
FOOTAGE:-J"1 ~ ~
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NAME OF UTIlllY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
Early Release " /I' Manufactured, /'
Permit: Y ~ N Trusses: ~Y N 0 CRAWLSPACE 0 POST & BEAM PIER
Lot Split: RELEJI',~ FOFf~~U~N N 0 SLAB BASEMENT(WALKOUT:_Y K N)
For Single Family an Tw~V3ffl-ih YJ.,f:).Ij;p.'t~ aal l1;i,g!ls r~fA~ ~?D..litor accessory structures, this permit is valid only if construction commences witlun 180
days of the date of issuan'c'e M\:i6.~q,iilldihg-~ :':I '~Q!irfust be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class 1
structure pe~ER11h..eft~9i~ji1in(s~~\!}ESte St,ate of Indian~ (See 675 lAC 12) regarding expiration time frames for beginning and
r.ITV n~ r'I\.Q , . comll!etmgconstructwn.
I, the undersigft'M1~ a~re't-that'affY'edM&!tiJn~YruTQWN~ltrf, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this application will com~ty~~~onform to, all applicable laws of the State of Indiana, and the ~Zoning Ordinance of Carmel Indiana - 1993" (Z~
289) and amendments, adopted under auth~rlty\ortt. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and Ooor dr ins are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Dcc cyhas been iss by the Department of Commuruty SeIVlces, Carmel, Indiana
. .- \CJ()'C.~ G~
r or Authori ed Agent Print 0
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
VSINGLE FAMILY
/Ci"'TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
******************
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? S8
S-3 . ':) t/
P.R.I.F,: / d-. c;, /. tJ()
(,/~~~) / J~1.
FeeRe~' ~
X ll,{,I1Shaded) ~
TYPE OF IMPROVEMENT:
~EW STRUCTURE
.el"'-ROOM ADDITION(S)
o PORCH ADDITION(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
PLUMBING CONTRACTOR:
'W>r\ bfG-'1
Plumber's Indiana State License #:
iOS~Qq
Which plumbing codes will be applied to the construction:
o International Residential Code w/Indiana Amendments
~niform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
~
OFFICE USE ONLY: *****************************************************
Filing Fees:
Base Inspections:
INSPECTIONS REQUIRED:
# Charged Re-
Reviews
Cert. of Occupancy:
I 'i...t-r-
Dept. of Community Services
S:Permits/FormS/ILP RESIDENTIAL
Additional Fees
80
Date