HomeMy WebLinkAbout06080077 Application
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City of Carmel/Clay Township vtpermit #:t)VD ~()()1,
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER lJTILITY
PROVIDER:
STREET ADDRESS:
T b 't 1 'f...>, e,...i\.e.~
,
t1ft ?/.;j i.
FAX: .
;J'J'fAJJ,ilL
CITY:
STATE:
ZIP:
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BEST METHOD OF CONTACT:
1. , ec. ..-.- ;C'.
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E- /h p, -;)
FAX:
ZIP:
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SQUARE ) I 1>
FOOTAGE: t!:I:3
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ESTIMATED COST Oi=;CONSTRUCTION:
(EXCLUDING LAND v,:-~Li7) i ;;. ~ \.~._"
"I ,!r. __..
jl~:'~ I Iii ;:1
,If 1i I U! } 1,1
TAX MAP PARCE~ ~:l J U ; i i " i :
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L____ J -- I
PLUMBING CONTRAf!~~~~_-,-..~__J
Plumber's Indiana State License #:
NAME OF1;OTiCfry EXCAVATION CONTRACTOR; PLAN COMMISSION I ZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (JF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
~!NGLE FAM!L Y 0 NEW STRUCTURE
o TOWN HOME 0 ROOM ADDITlON(S)
o TWO FAM!LY 0 PORCH ADDmON(S)
# of units being 0 DECK ADDmON(S)
constructed at this t><t REMODEL
time: _ Basement Finish only
~ RES!DENHAL (For 0 ACCESSORY BUILD!NG
V \.Additions, Remodels, Etc.) 0 DETACHED GARAGE
t.."",v,0 .5f, -+.e- 3 k..fp,.> 0 ATTACHED GARAGE
PROJECT INFORMATION: 0 DEMOLITlON
Early Release ~ Manufactured
Permit: _Y ~'-TrUS5es:
Lot Split: _Y Sump Pump:
~
Y N
Y ~------
Which plumbing codes will be applied to the construction:
o International Residential Code w/Indiana Amendments
o Uniform Plumbing Code w/!ndiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area) :;[".,t j.:ftl~j ~ \,
o CRAWLSPACE 0 POST&_BEAM_PIER
~ SLAB 0 BASEMENT (WALKOUT:_Y_N )
For Single Family and Two Family dwellings, additions, remodels, and/?kaH. essory structures, this permit is valid only if construction commences within 180
days of the date of issuan..s'f ~t.P~iItg~~,~iilt.dt:"'Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure permits are saJ!dt.tg~~A1hW.~drhlliis~a~k't; ~u~gmrm'-i~ of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
Subject to compllance WI a ~~mpletingconstruction.
I, the undersigned, agree that any c~5'rEftenate.drl.sO'OOloQ~i.gement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this application will cofrmly ~~ J\lljl~ '1j{tI\fR~aI::bfpA~of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana - 1993" (Z-
289) and amendments d9EsRild(d.tit~HflJYtY~:Ye~ se ~~i;,Il f the State of Indiana, and all Acts amendatory thereto. I further certIfy that only
kitchen, bath, and f1 or . . rT~}.t'i t that the construction will not be used or occupied until a fcEti!icateof
cupancyh i artme1~ ~tyServi, ~e,lndiana. ~
\ a. /~?:
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INSPECTIONS REQUIRED: Filing Fees: J / :3 3 . g
U F t" L F t. Under Slab Base Inspections: _ I / 0 # CRharged Re-
pper 00 '"9 ower 00 '"9 ' .. eviews
6~.50
0ou~0
Meter Base
~Site
Cert of Occupancy:
Additional Fees
Reviewed/App Dept. of Community Services
S:Permits/formS/IlP RESIDENTIAL
-c6
(Date)
P,R,LF,: TOTAL: ;1/:2!? (J if
~~9-~ ~/1~/o~
Fee Receive V' I ( ate