HomeMy WebLinkAbout06080186 Application
City of Carmel/Clay Township Permit #: aVO'! CJ it'!
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
NAME:
PROPERTY
OWNER:
NAME:
STREET ADDRESS:
LOCATION
& PROJECT
INFO:
LOT#:
J\/\
H
25
ADDRESS OF CONSTRU
\ 3'2-S6
ZU-6Z1J
77
PHONE:
FAX:
cm:
STATE:
ZIP:
SECTION:
ZONING: S _ I
SQUARE
FOOTAGE 2'
, ..,~, ,.. - J
\ ./' ,: '~;' :r~~\ 1
_ ,.' . _~.;.oll i ~ I
"-"~1111i
111111
Jl0'
NAME OF UTIUTY EXCAV nON CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNlY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
TYPE OF IMPROVEMENT:
~ NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured ~
~~~D J.~ =~
VlJOjec " F: I
For Single Family and Two Family dwe~s addttli;O~l"~,'f.,~.','!~' trUctures, this permit is valid only if construction co ces wi~hin 1 0
days of the date of issuance of the ~il 1 . ilia:ffiU.raR~~~ e. ,cupan, cy issued) within 18 months of the is cej!:ate. lass I
structure permits are subject to thefQJ~61E st~~'tis';;~~}<l!:~,bt~.~~~t. 7S lA, C 12) ~e~din, g ex~on tim frame ,for i m, g and
C; D' MU e~~., ,,', ~
I, the undersigned, agree that any construction, reconst~.t~ i;>pl~r,;e~~'oh.' or alteratl?,!l9_f a,,,ructur,, ,y c~ In t s~nd or st tut;eS
requestedbythisapplicationwillcomplywith,andconfom}~;-;na'p~\fal;rll\~~~' EIndiana,and'tf?e" 0 . ~or 'anc Carrn I 'an:J~931(Z~
289) and amendments, ado ted under authority of I.C 36-7 HVlq.&t1l:cyrjfAlse~M~&f Indiana,'an,d, a,ll AS', to t ere f hit,{ cqtify t~at only
kitchen, bath, and floor d In are connected to the sanitary sewer-.~ tfifttber certJY ~~ction willii~.t be use r occu led un a Ceri'1Kcate of
~1P~has en is e y the Department of unity Services, Cannel, Indiana...;., " . ,.
't\ I'(\)JV\\ C ,''''Act I-<-\~
Print
OFFI EUSE NLY:******************************~~*******************'***~:L:~****************
INSPECTIONS REQUIRED: Filing Fees: /0
uppeQing ~ng Under Slab Base Inspections: ~;~: ~
~ Cert of Occupancy:
'Rough Ii alSite ;).(j _ 0
P,R,LF,: __
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
v' '><'i SINGLE FAMILY
"d- TOWN HOME
o TWO FAMILY,
# of units being
constructed at this
time:
[] RESIDENTIAL(For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
_y LN
_ y ---L.N
Lot Split:
^
Reviewed Approved: Dept. of Community Services (Date)
S:Permits/ForrnS/ILP RESIDENTIAL
'License-# .
~mbing codes will be applied to the construction: i
~ International Residential Code w/Indiana Amend~ents
o Uniform Plumbing Code wI Indiana Amendments I
I
FOUNDATION TYPE: (Check all that apply for the n
<;onstruction area)
# Charged Re-
Reviews
I
Additional Fees
Fee Received by:
Date