HomeMy WebLinkAbout06080056 Application
City of Carmel/ Clay TOwns~'~
RESIDENTIAL IMPROVEMENT LOCATI PERMIT APPLICA>TION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory St~uctures
Permit #: ()(!oQ,,()Of:&
I
BUILDER of
RECORD:
PROPERTY
OWNER:
NAME
EL.
PHONE
FAX
STREET ADDRESS
CITY
STATE
ZIP
LOCATION
&. PROJECT
INFO: A DRE S f1?NSTR~Ar M (
SEWER UTIlITY WATER UTIlITY () ~ OS ODS-
PROVIDER: (..L,"'1 ,N51' (t.W. P. PROVIDER: C:.f\lLmEL wA-1i
SECTION
ZONING:
" .~~
~
-
NAME OF UTIlITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET ,~_
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPllCAB~
croo
&-;Al".AI' t eUTESZCA.VIt N<S
TYPE OF CONSTRUCTION:
fZ{ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT: "'v.
2f NEW STRUCTURE..yO ~~
o ROOM ADDmON(S) V "~~
o PORCH ADDmON(S) V'?<5<"'1< ZJ (, '5
o REMODEL ~~:. ~ _ ~.
o ACCESSORY BUILDING '~ut;l)1 . . ill be applied to the construction:
o DETACHED GARAGE ~~~ e\S("6ntia, Code w/Indiana Amendments .
o ATTACHED GARAGE ~' 0 .'V .
o DEMOLmON U Ld'Rill!l-,C~ w/Indlana Amendments
eMul ~1~~o"1;Pde)
i4ii 0 ~-::, /.
Manufactured FOUNDA PE: V(~h8Ck all that apply for the new
Y ~ Trusses: _Y v--N construction a . '9"
- 0 CRAWLSPA~' ,S>
Lot Split: _Y..0 Sump Pump: .0 _N 0 SLAB "'\Y
Does any part of the property lie within a special Flood designation area: _ Y rl
PROJECT INFORMATION:
Early Release
Permit:
o POST & BEAM
~BASEMENT
WALKOUT:_Y~
<1
For Single Family and Two Family dwellings, additions, remodels, ilnd/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 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 -1993" (Z~ 289) and amendments, adopted under authority of I.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts 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 C; wcate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
- ->tJ ~~ ~OdfYvttl-() t-7-6~
Signature of OWner Print Date
OFFICE USE ONLY: ** **** **** * *** ***** **** * *** ********* **** * *** ****** **********************
Filing Fees: t~lfi 0
Base Inspections: __~_ _
Cert. of Occupancy: <; J . :;-tJ
I~ G/. (}()
02 m 30
# Charged Re-
Reviews
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P,R,LF,:
Additional Fees
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