HomeMy WebLinkAbout06100016 Application
City of Cannel/Clay Township Permit #: 0& 10 obI (.1
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
PHONE:
1-317-111-;<93/
FAX:
NAME:
--rUFf~ SHED
STREET ADDRESS:
/S;;Z1 /-leRI?/I\1ItN Bl-vO
BUILDER
OF
RECORD:
CITY:
lYoi.31-ESlh LL..E
STATE:
"7ND/A tV ~
ZIP''k,060
BUILDER'S EMAIl ADDRESS:
NA!;\Eo / IE C e
&[E1U$ eJ "-a/S fIAR.D/II!
STREET ADDRESS:
//908 13RooKsfI/R.E; "PK
FAX:
PROPERTY
OWNER:
CITY:
CAR IYIE L
STATE:
:ItJDtf'r iliA
Z~033
ZONING:
LOT #:
SUBDIVISION NAME:
SECTION:
LOCATION
&. PROJECT
INFO:
SQUARE
FOOTAGE.
SEWER UTIlITY
PROVIDER: ~
NAME OF UTIlITY EXCAVATION CONTRACTOR; PLAN COMMISSION
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC
\,\:j 0
o
flOOD ZONE AREA DESIGNATlON(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
)8 RESIDENTIAL(For
Additions. Remodels. Etc.)
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL
/_ Basement Finish only
CB' ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
Which plumbing codes will be applied to the construction:
o International Residential Code w/Indiana Amendments
o Uniform Plumbing Code w/lndiana Amendments
FOUNDATION TYPE:
construction area)
PROJECT INFORMATION:
yv(
y~
(Check all that apply for the new
I
BEAM ~PIER
/
~y -~
~y~
Early Release
Permit:
Manufactured
Trusses:
o CRAWLSPACE
o
o POST &
Lot Split:
Sump Pump:
o BASEMENT (WALKOUT:~Y_N )
SLAB
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences 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 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.
I, 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 Carmel Indiana -1993~ (Z~
289) and amendments, adopted under authority of r.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. I further certify that the construction will not be used or occupied until a Certificate of
Occupanc has been issued by the Department of Conununity Services, Carmel, Indiana.
'(j, '1JeucLJ MIS Ii. HfiteDIN /0/:3/0'-
of Owner or Authorized Agent Print Date
OFFICE USE ONLY: **************************1******************** *******~**~********************
, FOIO F flU uO
INSPECTIONS REQUIRED: ling ees: . --
U F t' L f to U Base Inspections: ,s-,<;:../ill)
pper 00 mg ower 00 mg or-II
t 0 Certo of Occupancy: C;~ 0 . 2J/
Rough In(;let_i Base. - I
P.R.I.F.: Additional] Fees
.$I/noo
Reviewed/Approved: Dept. of Community Services (Date) I tl- 0'-iJ
S:Permlts/FormS/IlP RESIDENTIAL
# Charged Re-
ReViews
Date