HomeMy WebLinkAbout06080045 Application
City of Carmel/Clay Township Permit #OfoD?S on1j5
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
1)~Iv'C RELE~ii1OR COND{RUCTION ~~~.
om ~~bPdliMAilitmf>l. --.. /_
of SI",!. ~~lJ1NITI~'t'7Ii>I!II') ~ L- 'e-0:,Gi-;:;..\
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NAME OF lJTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA /,eFtvt~~ "" .. ~. :.:"-'~.: '1~ ~ ,'f ':'I_K .'.. ~ '-" ~ :~~____~-\' ~.rl \:X:.\\\ \\~
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT 1f~ ('IF ApP(rCA&:~HI\e)E,. i CU'I Y TQ\lVN8f1iP' \~3:" ,j ..'>/ '\\\ \\~
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Plumber's Indiana State (i'c; ___ ~
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BUILDER of
RECORD:
PROPERTY
OWNER:
f'E.-rt RSb l\I
STREET ADDRESS
1\5\4 :PO'NA. 'D~\VE
LOCATION
&. PROJECT
INFO:
=;#
"2/("
CSOBIiHVISIQN NAME
Wao1)L.. ND
~CN')F CONSTRUcnON
\ 6H 'D~"IA,
SEWER UTILITY
PROYIDER:
WATER UTILITY
PROVIDER:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
M RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
9." ROOM ADDITION(S)
l}'j PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
.~ih~c...
~r1}
PROJECT INFORMATION:
Early Release
Permit:
r Qr
,<;'7:;",(':(
BEST METHOD OF CONTACT:
dr. U),,-, ,
b'70..
PHONE
3;'1-5"1-"'\-'3\S3
FAX
cm
C,AR.'l-<'\E.L
ZIP
40032...
STATE
IN
SECTION
~.
-=
r 5- z.
7...3'5
<)1'~
b')"
PLUMBIN
Which plumbing codes will be ap'~ied to the ~~
o International Residential ~wllndiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
/ Manufactured /
Y ~ Trusses: Y ,/ N
./ 0 CRAWLSPACE
Lot Split: Y ____N Sump Pump: = Y ~N 0 SLAB
Does any part of the property lie within a special Flood designation area: _Y"/ N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences
within 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits arc 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 un er-signed, ree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or
stru res reql;!estc' y this application will comply Veith, and conform to, all applicable la\VS of the State of Indiana, and the ~Zoning Ordinance of Carmel
In ana;:. 9r 89) and amendments, adopted under authority of LC. 36-7 ct seq, General Assembly of the State of Indiana, and all Acts amendatory
th (6. r er certify that only kitchen, bath, and floor drains are connected to the sanitary sewer I further certify that the construction will not be
OT/ C~Piedunfil~.:ertificateoroccupancYhasb e DepartmercommUOl..ty Services, Carmel. Indiana. -.. / n,1 r>t. /
-". l'~)J~~C ~
SiU'} ture of Owner or Authorized Agent Print Da
***************~r** ***************//************************
t i'l.Mlin ees: f-OJ/ '7()
( ( . ase Inspections: 1& (;_ s-O # Charged Re-
Under lab ' ~-:>.. cll ReViews
Cert. of Occu pa ncy: -'..:2 2Y
OFFICE USE ONLY: *********
INSPECTIONS RE
Site
Meter Base
P.R.I.F.:
rs/ POST & BEAM
o BASEMENT
WALKOUT:_ Y_N
Additional Fees
# ?Ji'/ '/0
;ewedf oved: Dept. of Community Services
',it5/FormS/ILP RESIDENTIAL
\
Fee Received by: