HomeMy WebLinkAbout06090012 Application
City of Carmel/Clay Township Permit #:()~ () ~ OOfJ.
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
I
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
PHONE FAX
10 ;).3/
STATE ZIP
'5 :,t) [)
BEST METHOD OF CONTACT:
e.
PHONE FAX
CITY STATE ZIP
~ Manufactured ~
Y N Trusses: N
- - /r\I \ - 0 CRAWLSPACE 0 POST & BEAM
Lot Split: _ Y ----v Sump Pump: M &J SLAB 0 BASEMENT
Does any partofth ~,(;~~ 8 f~!lnationarea: -Y-O WALKOUT:_Y~
For Single Family and ~fiwti.tfcRgel . ~Ottak~~s, a~ccessory structures, this perm~~j~_Y~H~L~~!y'..~f CO.-ES_t~c:tion 5~..m__..TI?-e_n~~s
. within 180 days of the date of ise.1~~ t i Wn~rS(f.~\~e c~mpleted (Certificate of O<;~~I?,ain'f~;;i~s~ed) ~_~hi?i l~..~~~~ ~f1...nf 1
Issuance date. Class I st~eoFtaG ~O'tlilJ..'*'1?'\Wt41S'~'~tIve Ru~es of the State of In1~an~ (S~e6!~.:!~~~~~ re~~.:~~~?e)q~ifap~n
r6.RMe.Je19tG~lorlb~mningand completmgconstruction. \ \ III r --:1 j! 1 \1
I, the undersigned, agreMif'{np-lfn~ti~honti:l.?WK",\f~pn, enlargement, relocation, or alteration of a struqute:.b~ any change in the use of land l?F) j]![
structures requested by thi; application will cOltt~~Vit'l\:and conform to, all applicable laws of the State of Indii~ hJ?d th~frni~~it~of Citmel,"
di 'II J 1(- 'll ' ,
In 'ana -1993" (2-289) and amendments, adopted under authority ofI.C. 36-7 et seq. General Assembly of the Stpte OI!lndi od ct datory ) J i
thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further bi::hifYlthat the construction will n6LbSi I
us occupied until a Certificate of occ~pancyhas heen issued hy the Department or Community servifes, ~:.\.melcIndiana"'----- J. I
, no.nlc.,p 8;--PIJr1-nOU-I-c. ::2ii:zrsL2(,!
SI ature of Owner or Authorized Agent ~t Date
OFFICE USE ONLY: ************************************************~~********************
Filing Fees: (p "lS "0 , ?vO i
INSPECTIONS REQUIRED: "7 7 ~ r-O '
r.::... .-' - ~ Base Inspections: ^. ~ I # Charged Re-
~per Footin.ll Lower Footing ~ ~O ReViews
---- Cert, of Occupancy: .
~0'ii9~~r B~ Final Site JJ-€/! , 0 rf) AdditionaTFeeS ~
-1J.1-.~O. ').0 / j
-- t q- /~/'
PROPERTY
OWNER:
STREET ADDRESS
LOCATION
& PROJECT
INFO:
LOT #
<ell I
SEWER UTILITY
PROVIDER:
WATER UlltPJ - II
PROVIDER:~
OR; PLAN COMMISSION / BZA / BPW DOCKET
WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
TYPE OF CONSTRUCTION:
. 0 SINGLE FAMIL~.1
~TOWN HOMElL"l(
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
a-r.EW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
PROJECT INFORMATION:
Early Release
Permit:
ZONING:
SQUARE
FOOTAGE: ;;2.99 ,;)
PL~rBING C' TRACTOR:
~(7-(~T;u;;
Plumber's Indiana State License #:
(7-r'/OCOO /(J /
Which plumbing codes will be applied to the construction:
~ International Residential Code w/Ind;ana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)