HomeMy WebLinkAbout06090015 Application
City of Carmel/Clay Township Permit #: 0 feCfloe/S'
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, 8< Two Family: New Structures, Additions, Remodels, 8< Accessory Structures
PROJECT INFORMATION:
Early Release f\ Manufactured IS
Permit: Y ----l:!)Y Trusses: ~ N
Lot Split: Y -=0 Sump Pump: ~N ~~WLSPACE g ~M~~~M
Does any part of the property lie w. . lood designation area: Y ~ WALKOUT: Y N
For Single~PA.~ ~ . y Z~~ ~,remodels, and/or accessory structures, this permit is valid only if construction commences
within 18~~'Ot.ifo ~~~i~o.{~t tifling P.s.~ and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance datS~1 s~ ~niu~s 1et:J.l1\~~al Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
o a 1\h'N,UN\ .trll1~~ningandcompletingconstruction.
I, the undersilPltd.f?Wt{):1!atCbt ~oJ1~trl.j~Aotol~~~e'nl;.;gement, relocation, or alteration of a structure, or any change in the use of land or
structures req~a !At: ~~?W~ly with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Cannel
Indiana -19~~~bna-"aillen~\~ under authority of l.c. 36,7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
ther o. I further certify that only kNch~, bath, and floor drains are connected to the sanitary sewer. I funher certify that the construction will not be
eel occupied un. CertiFicate of Oc~upancy has been issu~d b tbe Depanment of Community Setvlces, ~eI, Indiana. /. /
~V1IC.-P &..p i/?fYIOUII' 'is,gi5~
Si ature of OWner or Authorized Agent P . Date
OFFICE USE ONLY: ** ****** **** ************ *** ** ************ * ******~"*** *******************
Filing Fees: ftJ 7 ~ . & 0
INSPECTlONS REQUIRED: /7 77. ~o # Charged Re-
Base Inspections: -.C. _ _ ~
nder Slab S 3 r..-n Reviews
Cert, of Occupancy: ::) [..I
/).. ~I . 0 f)
. $/ ~;z..iL~. faD
3-oz,
BUILDER of
RECORD:
PROPERTY
OWNER:
STREET ADDRESS
LOCATION
8< PROJECT
INFO:
mllACTOR; PLAN COMMISSION / BZA / BPW DOCKET
R COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
TYPE OF CONSTRUCTION:
~ SINGLE FAMIL~Y
dZI TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
~NEW STRUCTURE
o ROOM ADDmON(S)
o PORCH ADDmON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
Site
Final
c
Reviewed/Appr ved: ept. of Community Services
S:PermIts/FormS/lLP RESIDENTIAL
cm
STATE
ZIP
ZONING:
SQUARE
FOOTAGE: d. 85;
~
Plumber's Indiana State License #:
~1YY)() Jo J
.
Which plumbing codes will be applied to the construction:
~ntemational Residential Code w/Indiana Amendments
o Unifonn Plumbing Code w/lndiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Additional Fees