HomeMy WebLinkAbout06100082 Application
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City of Carmel/Clay Township Permit #/)0/ oOO8d.-
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
PHONE:
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NAME: I
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FAX:
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BUILDER
OF
RECORD:
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STREET ADDRESS:
STATE:
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ZIP:
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BUILDER'S EMAIL ADDRESS:
BEST METHOD OF CONTACT:
PHONE:
N~E';o7ljJ J- i;o"M ""JA.=6
FAX:
PROPERTY
OWNER:
CITY:
COn->t<.-1
STATE:
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ZIP:
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LOT #:
I
SECTION:
LOCATION
&. PROJECT
INFO:
ADDRESS OF CONSTRUCTION:
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SQUARE
FOOTAGE: 2..'7 L
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SEWER UTILITY
PROVIDER:
WATER lJT1LfTY
PROVIDER:
ESTIMATED COST OF CONSTRUcrrON:
(EXCLUDING LAND VALUE) ~ 3 s;- .<po 0...--.,
1-- "lli? ~ i':.; n ',,",\11 \2 "\1'1\1
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TAX MAP PARdEJ 1,1\ \ I \ I
II \ 1 2006 !I
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Plumber's Indiana S te License #0
NAME OF UTIUTY EXCAVATION CONTRACfOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(s); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE):
FLOOD ZONE AREA DESIGNA~N(S)
FOR THIS PROPERTY: ~~
TYPE OF IMPROVEMENT:
TYPE OF CONSTRUCTION:
.. SINGLE FAMILYA.J
o TOWN HOME 1~
o TWO FAMILY /'
# of units being
constructed at this
I time:
r!iJ RESIDENTIAL (For
Additions. Remodels. Etc.)
o NEW STRUCTURE
til ~ .......,a.-I:.-~LlUJ I JuN(S)
~PORCH ADDITION(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Which plumbing codes will be applied to the construction:
o International Residential Code w/Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
PROJECT INFORMATION:
Early Release ~ Manufactured
Permit: Y NTrusses:
Lot Split: Y ~ Sump Pump:
FOUNDATION TYPE: (Check all that apply for the new
construction area)
_Y~
_Y~N
o )'RAWLSPACE 0 POST & BEAM PIER
[!'( SLAB 0 .BASEMENT (WALKOUT:_Y_N )
For Single Family and !~o F~i!y'dwellin~~d9.i..~~~m~l\fcessory structures, this pennit is valid only if construction commences within 180
days of the date of i~~AIitlii.&ild\1.g-pehfut~H 'ri\us\: bVdf~p.fMed' (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure pennits are~~ ~@SAA~jA~tlibli.aJ~ll.O~~ite of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
...------- f State..ana Local Codes. completing construction.
I, the undersigned, agree that any <(onstructlon, rer.?l}tt!1l~911c~ptP"~ cation, or alteration of a structure, or any change in the use of land or structures
requested by this applicm.~iWl1 ~1YJ.:QtvlM ~nKMn to,"lilt:app!Yc'abf s of the State of Indiana, and the "Zoning Ordinance of Cannel Indiana - 1993" (Z~
289) and amendmentWP9t;!1j.eQ.tj~dJ:a"t~in:s>f I.Q:.~t?Ar..se ,0W of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floMdJ.i!s ~lQ6hnti~felnblth~damta I er. I further cert' that the construction will not be used or occupied until a Certificate of
~has been issued by tIe D~.....?-~ ni5Y.Se'~ces. C J, Indiana.
/. ~ ~ . . 6l' j."'o ;J 41j,"r~ )r lol/llb,
Signature of Owner or uthorizecl A .... t ~ Date
**********************************************************
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Filing Fees:
Base Inspections:
Cert. of Occupancy:
INSPECTIONS REQUIRE "
Lower Footing
F~
# Charged Re.
Reviews
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Additional Fees
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Reviewed/ Appr
S:Permits!FormS/ILP RESIDENTIAL
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(Date)
Date
Fee Received by;