HomeMy WebLinkAbout06100040 Application
City of Carmel/ Clay Township Permit I:i,IO(}fY-f{)
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
I
PHONE: FAX:
2 f) )~. 9' 7 ..
~
,
,(.y.QI~~,~./
BUILDER
OF
RECORD:
NAME:
~
flv,..~,
STllfET AOORESS~~() 0
V"t:
I-..>J<. <
PROPERTY
OWNER:
NAME:
STREET ADDRESS:
LOCATION
&. PROJECT
INFO:
LOTI:
SUBDIVISION NAME:
~
SEWER UTIlITY fl
PROVIDER: ,-Tt "-Iff)
NAME OF Ul1UTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW OOCKET
NUMBERS; TAC OATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT ,'5 (IF APPLICABUE):
TYPE OF IMPROVEMENT:
~ STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
PROJECT INFORMATION: a 0 DEMOLmON
Early Release J W Manufactured /'
Permit: _Y.Y..j.N Trusses: _~N
Lot Split: _Y ~N Sump Pump: ~Y _N
TYPE OF CONSTRU
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
CITY:
G">.J5/'
cm:
ZIP:
'162 0
E- pl&( I lof1 }O'(l
RELEASED FOR Crn~STRUCT10N
Subject to compliance with all regulations
of Stal\ffil1\D. _oca 0 ~,
DEPT OF COMMUNITY SERVICES
CITY OlEcGlI.RMEL l~ N :
( ~lf\ 'lA
(0
> .
PHONE:
SQUARE
FOOTAGE:
llIJ-b
ESTIMATED COST OF CONSTRUcnON:
(EXCLUDING LAND VALUE) _______
~'lL '~.'
((l/ 7? 7 'T..'ol-V"
Which plu.mbing codes will be applied to the construction: ~.
~mational Residential Code wI Indiana Amendments
o Unifonn Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM PIER
IB"SLAB ~MENT (WALKOUT:_Y ~) .
,
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit 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 pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 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" (ZI
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
Occupancy has been issued by the Department of Conununity Servim. Cannj?ndiana. _ _-
~7~~ -~~_-r ~C (Rect:- /eJ-.>-O-6
Slg re of OWner 0 uthonzed Agent Print Date
OFFICE USE ONLY: ****** * ****** *****************~~*****************~***l]*****j;**** * ***** *******
INSPECTIONS REQUIRED: Filing Fees: JLtJ -' '-_bL
Qil F t- q) Ii: F to=-" U d SI b Base Inspections: ?rr 7, ..5 0 # Charged Re-
-...;;.:_oer .....00 In_ ,ower on I~ n er a r? 5() ReVIews
~ Cert. of Occupancy: ~ ..:\ r _ I
c"'ROugh_In.:.::>_~ Bas~ Final Site ~ () 0 I
_ _ ~ _ ,Additional Fees
)3,q(" ~DI
. I
(Date)
Reviewed/Approved: Dep
S:Permits/FormsjIlP RESIDENTIAL
Fee Received by:
Date