HomeMy WebLinkAbout06080142 Application
City of Carmell Clay Township Permit #: OlROl< 0 JJ..{~
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:
NAME:
't
PHONE:
vI
2:, -Ct5IY
FAX:
oil g</~ r;o-,
ZIP:
W
B~D OF CONTACT:
t\CXU
FAX:
::en
STATE:
---0
z~
SQUARE '1 , I
FOOTAGE:~~I~
SEWER UTI~. _ '" WATER UTII.Ilfi\ '0"""'- {J \"""'. ^ (\
PROVIDER: L:.-' Ll.A.) D PROVIDER: GH\CJ ~
NAME OF UTIllTY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
FLOOO ZONE AREA OESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
\[$ TOWN HOME
tJ TWO FAMILY
# of units being
constructed at this
time:
o ItESIDENTIAL (For
Additions. Itemodels. Etc,)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_V$N
_V~N
ESTIMATED COST OF CONST)l!Imo
(EXCLUDING LANO VALUE) 0(5
2\l-i6
TAX MAP PARCEL #:
'r!J NEW STItUCTUItE
E'J ItOOM ADDITION(S)
o POItCH ADDmON(S)
o DECK ADDmON(S)
o ItEMODEL
_ Basement Finish only
o ACCESSOItY BUILDING 0 Intemationalltesidential Code w/Indiana Amendments
o DETACHED GAItAGE "rk
o ATTACHED GAItAGE T' Uniform Plumbing Code w/Indiana Amendments
o DEMOLITIO~ FOUNDATION TYPE: (Check all that apply for the new
Manufactured ~l.E:;qs. construction area)
Trusses: ~D J::OR 0 CRAWLSPACE 0 POST & BEAM _PIER
Sump Pump: Dl:iirv,.~:IJ/i"f)C;Otv*,SLAB 0 BASEMENT (WALKOllT:_Y_N)
Which plumbing codes will be applied to the construction:
For Single Family and Two Family dwellings, additions, rem ~RnH;t! , ~~ _ _ i{1'F>>W_t i ~ only if construction conunences within 180
days of the date of issuance of the building permit, and must be co \feijl(~iafiU1'9?:W~cUP~,,",Y lsW~thin 18 months of the issuance date. class I
structure pennits are subject to the General Administrative Rules of the Star~i'ei'J~jl ('self 8~ C 12) reg;J!ing expiration time frames for beginning and
completiU&,f'Wstrbili'1" " V/01O-_ '
I, the undersigned, agree that any construction, reconstruction, enlargement, relocat~it..6l' <tltedti~5u~~rany change in the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of th; Sfa.~e of Indiana, .. oriing Ordinance of Carmel Indiana -1993~ (Z'
289) and amendments, adopted under authority of LC. 36,7 et seq, General Assembly of the State of Indiana, an ts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
:rnf5~~rBTlofCOmmUnitysemce\~diQ~ l \ g I O/1)lp
Signature of Owner or Authorized Agent Print Date
OFFICE USE ONLY: *************************************************************~******************
F'j' F . h 30 J ()
INSPECTIONS REQUIRED' ling ees. .
, . . ~ Base Inspections: d? 7. ;)0
Upper Foot, Lower Footm n er Sial?..) ~ ---0
Cert. of Occupancy: 6 :3, 0 c
(; ()
if ;;Jc?2,),;) s-o
I-D
# Charged Re-
ReVIews
(Date)
Additional Fees
Revlewedj Approved: Dept. of Community Services
S;PermitsjFormS/llP RESIDENTIAL
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