HomeMy WebLinkAbout06100041 Application
City of Carmel/Clay Township Permit #: (jt/j ffl 1./1
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
I'
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
SEWER UTIUTY
PROVlOER:
I(
BUILDER'S EMAIL ADDRESS:
sbro r",;t.nfl tff3. j,dtnvm - ro
NAME:
?tvcfn e H-IUH'f f sr Ar~S ae
STREET ADDRESS:
Q:r ttJe~rp{)llJrt [)e. 5i1ITt 6(l()
lOT #:
SUBDIVISION NAME:
FAX:
"7;7/7- qo~L/37q
S'~rrt' fkL/1<Et..
\-e.....-
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF IMPROVEMENT:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
ACCESSORY BUILDING
DETACHED GARAGE
ATTACHED GARAGE
DEMOLITION
--.
Lower Footing Under Slab
Final (-;J
Meter Base
.5~
(Date)
pproved: Dept. of Community Services
S;pennits/Fo s/ILP RESIDENTIAL
Print
OSlJ
NAME OF UTIlITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WEll ANDIOR SEPTIC PERMIT #'S (IF APPUCABlE):
o
o
o
PROJECT INFORMATION: )(
. . . "',.. F.............tt\ftedJUCTION
~~L~A,:lt:D ,-.:"",~",,,~..,
Y N ,Trusses: h II ""'1b4<;-N
SUj)F~Cl [0 {:Ompllatile Wit, a reg~ .
~y -e++~tate a~H"!~pP.~~p~)des.-Y _N
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For Single Family ~dT~~F~y\L~iWkg~,'ad~i,~i~,ns, 'i'~(~~f~ist~...ffl3Ccessory structures, this permit is valid only if construction commences 'Within 180
days of the dat(9{ ~aij:;ofJ:h'e.building_pbrtmt,AUla n\.ust b~ tC'lnrpleted (Certificate of Occupancy issued) within 18 months of the issuance date, Class I
structure permits are subject to the Ge,e-ralJldminiA,trative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
I \i . r"\1 '" 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 -I993~ (Z'
289) and amendments, adopted under authority of LC. 36'7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, ath, 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
Occup cy has e ued by the Department of Community Services, Carmel, Indiana.
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Rough In
TAX MAP PARCEL #:
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PLUMBING CONTRACTOR:
ovv
Early Release
Permit:
Lot Split:
Plumber's lndiana State license #
,
o International Residential Code w/Indiana Amendments
I
o Uniform Plumbing Code wi Indiana Amendments
I
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE
o
o POST &
BEAM _PIER
SLAB
o BASEMENT (WALKOUT:_Y_N )
9-22. -o{,
Date
OFFICEUSEONLY:*********************************************************************************
INSPECTIONS REQUIRED: Filing Fees: <$" 133. 5D
Base Inspections: .$ 55.50
Upper Footing
# Charged Re-
Reviews
~'5?O, r'f)
Additional Fees
(I Add. B1dj.)
o UJ
Cert. of Occupancy:
P.R.I.F.: