HomeMy WebLinkAbout06100101 Application
City of Carmel/Clay Township Permit #: tHaI 00 tOJ
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
STREET ADDRESS
BUILDER of
RECORD:
CITY
STATE
~
BUILDER'S EMAll ADDRESb
i-kY\ \C!.
.UYY)
PROPERTY
OWNER:
PHONE
3n-~
LOCATION
& PROJECT
INFO:
SQUARE
FOOTAGE-
<6(
ESTIMATED COST OF CONSTRUcnON.\
(EXCLUDING LAND VALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
'i!qo
./
~ 001 o~
PLUMBING CONTRACTOR:
pE,e~'L~~~~ License #:
_lD~
€.Q \W
TYPE OF CONSTRUCTION: "nO TYPE OF IMPROVEMENT:
o SINGLE FAMILY ~ 'O"'.J. Vl NEW STRUCTURE
'r5cr TOWN HOME ;..I -;c9~ 10 ROOM ADDITION(S)
Ib- TWO FAMILY \l\~ 0 PORCH ADDITION(S)
# of Units: 0 REMODEL
o MUL TI-FAM.IL Y 0 A.SS~RY BUI.LDING Which plumbing codes will be applied to the const. ruction:
o R:s~6~~~AL (For is ~~~~g~ )(i Int.ernational Residential COde.w/lndi~ra Amendments
Additions, Remodels, Etc.) 0 ~~.LI'~ ... ....'0 b Uniform Plumbmg Code w/lnd,ana Amendments
:,,~)O[~ (' ~O (Multi-Family Construction Code)
PROJECT INFORMATION: ~l;,""l'Q.. Of 8.t~;'."I)^';4 ~ c:
-:"1'.J'!i....~ ~.O "I'! (Check all that apply for the new
Early Release V Manufactu~ C'~ .. '>1i':f.,CfJ 11.
Permit: _Y -f')-N Trusses: V~~Oc. ~
Lot Split: _ Y $N Sump Pump: ~~~ tfI; 00 is ~~~M&E~~M .
Does any part of the property lie within a special AO~~~ ~ i N WALKO\Jf::-.'~\\rr;. ~ N
For Single Family and Two Family dwellings, additions, remodels. an I r acces s, this permit i~ val~ 6nly_i'icrin~'t-rucifon ~~mmJnces
within 180 days of the date of issuance of the building permit, and must be compIe ficate of Occupancy, i#ucd) within 18 months of It he
issuance date. Class I structure permits are sub~ect to the General,Ad.ministrative Ru~es Stat~ of Indiana (Se~1675 lAC It) regamdin~51cPiration
Ume frames for begmmng and completmgconstructlon. -, \ \ OC\ \ L
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land OT;
structures requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "ZoningQrdinance"ofCarlnel
Indiana -1993" (Z- 289) and amendments, adopted under authority of LC. 36-7 et seq, General Assembly of the State of Indiana;-and all Acts amendawry
thereto I further certIfy that only kitchen, bath, and floor drams arc connected to the Iti~f\ sewer I further certIfy that the constructIOn will not be
us r occup<< untIl a Cer /fi ate of Occupancy has bee2' .ssued bY,'ci:rm ~ ~~rs, Ca,mel.lndlana. ~ f k }(Y ~
Signature of Owner or Authorized Agent Print ~
OFFICE USE ONLY: ***********************************************~*~**********************
Filing Fees: 6- ,(../2, J () ,
INSPECTIONS REQUIRE . .' ' .' !
,....,-;: ~_':'7.l Base Inspections: ;/7 ~SO # Charg,ed Re-
'-- Upper ~g Lower Footin Under Slab . - --z; ReViews
~. ~ Cert, of Occupancy: ..{, :3. c") I
<.. -"--::.:::~. _ ,::eter ~e Site P,R.I.F.: /02 (;1 (}O Additional Fees
" ~~~
.
Reviewed/Approved: Dept. of Community Services (Date)
S:PermitsjFormS/ILP RESIDENTIAL