HomeMy WebLinkAbout06080141 Application
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
City of Carmel/Clay Township Permit #: () CR0'80J~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER'S EM~L ADDRE~
BEST METHOD OF CONTACT:
FAX'
31 '7 f?/ r:-r;V /'I
cxf0~{Y()
SEcn~m J
Z01\J
SQUARE ~~
FOOTAGE:~
SEWER UTILITY WATER UTILITY _ _ I
PROVlDER:(}]12...wD PROVIDER: C>> (U1
NAME OF UTlLTIY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPliCABLE):
:;!415
ESTIMATED COST OF CONSTRU
(EXCLUDING LAND VALUE)
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TAX MAP PARCEL #:
TYPE OF CONSTRUcnON:
~D SINGLE FAMILY
TOWN HOME
TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
TYPE OF IMPROVEMENT:
~
NEW STRUCTURE
ROOM AODITION(S) Plumber's Indiana State Lice
o PORCHADDmON(S) ~OO
o DECKADDmON(S) ~ _lL-A .TI -,
o REMODEL t F' 'h _0- ~l.~l:'IIICh plumbing codes will be applied to the construction:
Basemen Im$ ofVW/u ""f. '/':
o ACCESSORY BUILDING '7'1l'ct '1hl"""'ltion a.l. R.esidential Code w/Indiana Amendments
o DETACHED GARAGE D. Oh. "'"y", , ,
o ATTACHED GARAGIi 'l!:P.,. 0 _~m~ PIu~1l9 Code w/Indlana Amendments
o DEMOLmON vl7y 0 &~Cs~.' ")''''''U&..rk
Of:' C ::, _ '1~;,~'70 all that apply for the new
Manufactured J ~ ~ 'R~ O'~l '(;/J/lItt 'tv
Trusses: ~Y _N IN, 1.. . ZlIiI3l~~" ~l7foST &_ BEAM _PIER
Sump Pump: ~Y _N 'Dl s&lB /"'<9) ~ (WALKOUT:_Y_N )
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_Y~N
_y'Y=-N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid on~ lf~struction commences within ISO
days of the date of issuance of the building pennie, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana -199r (Z'
289) and amendments, adopted under authority of LC. 36'7 et seq, General Assembly of the State of lndiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, a d floor drains are connected to the sanitary sewer. I further certify that the cons.truction will not be used or occupied until a Certificate of
o un' ue bye e D _ >remenef Communiey semmiO~; Inp,4 (1 rei I ~ II ~ I Dlp
Signature of Owne.- Dr Authorized Agent Print Date
L
OFFICE USE ONLY: ***************************** *********************************~*****************
F'I' F . I.. '30 . (::)
SPECTIONS REQUIRED" ling ees. n ,
- Base Inspections: ;).17 )tJ
5"3 - )'0
I;)C
# Charged Re-
Reviews
Cert, of Occu pa ncy:
gh I
uJL
Reviewed/Approved: Dept. of Community Services
S:Pel'mIts/FormS/ILP RESIDENTIAL
AddiUonal Fees
(Date)
:JJ:TAL'
by:
Date