HomeMy WebLinkAbout06080109 Application
City of Carmel/ Clay Township Permit #: 00 0 ~ol 01
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 UTILITY 1\
PROVIDER: G
BUILDER'S EMAIl ADDRESSmffi
NAME:
STREET ADDRESS:
LOU: , 0 7
ADDRESS OF CONSTRucnON: 3
WATER UTILITY
MD PROVIDER:
FAX:
CITY:
STATE:
ZIP:
SECTION: ZONING:
SQUARE
FOOTAGE:
ESTIMATED COST OF CONSTRumON:
(EXCLUDING LAND VALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
XSINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
. PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_Y~N
_Y VN
NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
Manufactured
Trusses:
Sump Pump:
~_N
_YI./N
10
Which plumbing codes will be apph
o Intemational Residential Co ndiana Amendments
~Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE
o POST &
BEAM _PIER
SEMENT (WALKOUT:_Y_N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory Stru.>(l. IS v~iOli'lY'if construction conunences within 180
days of the date of issuance of the building pennit. and must be completed1..~~f~ '6t c~~Q~within 18 months of the issuance date. Class I
structure permits are subject to the General Adminis.uative Rul~~~'rit \,f'rh.4!M\tJ~~~~\'cJ3~~ardin.z. ~ration time frames for beginning and
~r.:J.In1lJ'OlQlliI<'il<IM LOC3 C'c:p.\J\vt:""
I, the undersigned, agree that any construction, reconstruction, enlar6tPiij~'l"e)o~~~aflH::atj~q'f'l.W~U~, 0 the use of land or structures
requested by this application will comply with, and conform to, all applicable lawS"olth~Nft'tH~\ a~~ r inance of Cannel Incliana -1993n (Z~
289) and amendments, adopted under authority of LC. 36~7 et seq, Gene~~oe\i1G'~'6re t f I*~d a 1 Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I f~rU~~eA~ s ~,*~~I not be used or occupied until a Certificate of
Occupanr h", been ,,,ne y the Department of Community se"'ty\~~~~(; rc:ce ~ 17 ~
Print "-J Date
OFFICE USE ONLY: *********** *******************~~********************Z**)11**9'O*****************
NSPECTIONS REQUI' FIling Fees: - ---"- -
-. Base Inspections: ') "7 7. :50
Lower Footin c;z::.
Cert. of Occupancy: , ').] . ,;) ()
I,) (, I ()O
-fA dOTAL; , $ ;2ClrJC. jtJ Ic0
Fee~ . Uk~ ) J~
P.R.I.F.:
Reviewed/Approved: Dept. of Communi
S:PermJts/FormS/IlP RESIDENTIAL
# Charged Re-
Reviews
Additional Fees