HomeMy WebLinkAbout06090114 Application
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City of Carmell Clay Township Permit #:Oh 09 tJ /J +
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
NAME OF UTIlITY EXCAVATION CONTRACTOR: PL4N COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
---.... \
FLOOD ZONE AREA DESIGNATION(S) /~:;;: ~---~~<~~
FOR THIS PROPERTY: /11 \'~ , \ \
..........."" ~/'\\\ \
.......-/.) '\ "/' ,\ \\
TYPE OF CONSTRUCTION~.~, \\ TYPE O~II\1PROVEMENT:
~ ,/ /'r'A '\~ \\\ II \
';JJ SINGLE FAMIL~ \.',I) ~;ST)UJCTURE
o TOWNJ:t~M~\0~',"'/ <\ ~vRO~ADDI!ION(S)
o TWOFA~I~X\< 'l.. l- 0 P,9RCHADDIDON(S)
# of un!~ ~~IQg , ",,<8 C:,VOECK AJ?DrfiON(S)
constructeiL'at'~h%S" RE~EL
time: \\ \ ~ \ ~!-".sement Finish only
o RESIDENTIAL' f' ,) I2J ACCESSORY BUILDING
Additions. Reri..'<<id:;VIS' Etc,) 0 DETACHED GARAGE
\ 0 ATTACHED GARAGE
PROJECT INFORMA N: 0 DEMOLITION
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER
PROVIDE
STREET ADDRESS:
Early Release
Permit:
Lot Split:
_v-Q\
_V --t:/
4~ N
---t:!/-N
cm:
STATE:
ZIP:
Manufactured
Trusses:
Sump Pump:
ZONING:
01
Which plumbing codes will be applied to the construction:
~mational Residential Code wI Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area) -0Jt I ();1G\1,sheJ ~r
o CRAWLSPACE 0 POST & BEAM _PIER
o SLAB BASEMENT (WALKOUT:_V----Q1)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is valid only:if construction commences within ISO
days of the date of issuance of the building pennit, 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 IAC 12) regarding expiration time frames for beginning and
completing construction.
It 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 Cannel 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. 1 further certify that the construction will not be used or occupied until a Certificate of
cy has been '""ued by the Department of C~mmunity sevartUel' Indiana. '/.; !t
I:>Vl/Cf'S+.ei/,M('JUIC I. ',;2./ tJr;a
of Owner or Authorized Agent ate
OFFICEUSEONLY:**************************************************************~....**************
INSPECTIONS ~E~UIRED: Filing Fees: !'l.l d- 0
~ootij!g) ~r r 6 -;) Under Slab Base Inspections: d? '2 :5 0 # C~:~~e-:;5 Re-
~ ~ ~EL~FOFt~@I:~ltoN 53, So
,-)l!nu<l:!!;lJY lo,.r"eter B~ ~na.;., ,,'V~I~ ~pliajl~,r.~~ all regulations 't/ () 0 Additional Fees
of State and Local Codes, .//
UEPT OF COMMUNITY SER\JItO~L: -p ;2. 020
, Dept of Community SeeffV @Fit€ARMEL/ CLAY TOW
S:Permits/Form SIDENTIAL IN. d by; Date