HomeMy WebLinkAbout06080194 Application
BUILDER of
RECORD:
City of Carmel/Clay Township PLtll1 Permit#: 8foJAorlti
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Sttuctures
I
I
STR~0D
( "B,dI~ER'S EMAIL ADDRESS,
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'<$1.10-72
FAX
57 L{-7
'BEST t1ET1;lOD'OF CONTACT:
ZIP
~ ,a /;j
PROPERTY
OWNER:
-",....".
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FAX
WATE
LOCATION
& PROJECT
INFO:
SE3
SEWER UTI
PROVIDER:
SQUARE D
FOOTAGE: ~
ESTIMATED COST OF CONSTRumON. : D
(EXCLUDING LAND VALUE) 2-5 W
NAME OF UTIUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUN"TY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR: ~ I I II
o NEW STRUCTURE I~ If1
o ROOM ADDmON(S) sumber's Indiana State License #:
MRCH ADRf!10N(~
REMODEL~~k1Tdt
o ACCESSORY BUILDING Which plumbing codes will be applied to the construction:
o DETACHED GARAGE 0 International Residential Code w/lndiana Amendments
o ATTACHED GARAGE 0 Uniform Plumbing Code w/lndiana Amendments
o DEMOLmON (MUlti-Family Construction Code)
o UCTION:
SINGLE FAMILY
TOWN HOME
TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
~ RESIDENTIAL (For
^ Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release ~ Manufactured ~
Permit: Y Trusses: Y N
- - 0 CRAWLSPACE ~POST&BEAM
Lot Split: _Y N Sump Pump: _Y 0 SLAB -r- BASEMENT
Does any part of the property lie within a special Flood designation area: Y XN WALKOUT:
FOUNDATION TYPE: (Check an that apply for the new
construction area)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures. this permit is valid only if construction amm ces
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 1 structure permits are subject to the General Administrative Rules_ofthe Stateof.Iildhna (See675-IAC 12) regarding expiration
time frames for beginning and compl~~if1g'fq~~~n%i~o~c~;_5L~~!_"~\ \ \ \ \ \
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation,lpr;al]:eiation ofa'structure, or any ch\iflge '!nithe use of land or
structures requested by this applicaoon will comply WIth, and conform to, all applicable Li~s:qfkhe State of Indiana, and the "Z,~~g Ordinance of Carmel
Indian 1993" (Z;289) and amendments, adopted under authonty of I C 36-7 et seq, G~erlil= Y\~emblll~f..th~9te 9~ana; :md~an Acts amendatory
theret . I rther certify that only kitchen, bath, and floor drains are connected to the Sanlt~\r~wer J>All:ih~ c~~at the ~omM'uction will not be
used upJed u a c..ertiFicate of Occupancy has been issued by the epartmenc'f(f \'\ nity se,~~<kna. ~116Lc
--;;.....-- Date
OFFICE USE ONLY: *******. ******~********** **************************~*****************
~5 ';) d ling Fees: / :3J 3. .1 iJ
INSPECTIONS REQUIRE : I' ' .
Base Inspections: / II. 11 0 # Charged Re-
Upper Footing Lower Footing Un et. <"> '-0' ReVlews
~~ Cert. of Occupancy: , 2.Q':>
ough In Meter Base ~ Site
~/ P.R.I.F.: Additional Fees
CV'Ov~
Reviewed/Appro ed: Dept. of Community Services
S:Permits/FormS/ILP RESIDEmIAL
~;-Of,
(Date)
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