HomeMy WebLinkAbout06100132 Application
City of Carmel/Clay Township Permit #:~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
NAME:
v..&J..Ii.~ ~
STREET ADDRESS:
\\\eo. 0
BUILDER'S EMAIl ADDRESS:
I~ 4--@
NAME:
STREET ADDRESS:
'-"'5
LOT #:
~\
SUBDIVISION NAME:
Q.\.\
ADDRESS OF CONSTRUCTION:
~
RELEASED FOR C.,'" ;,\,.: "594~RE III
~ -ect to CO"~pnm'c~ V~'H!~; :n:, ~\. ~p:.omAij[ C\ C\
SEWER UTILITY 'I WATER UTILITY ~~~i'Eb'1:&1' OF'~Q&siRu~rftW," E ~
PROVIDER: [a.ny)e.! --mv' PROVIDER: CttvrneJ DEP (~1J@@!',!;'ijli!"A~)1 r ::> . g:. ' ~
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET CITY OF (II / ;;;:."
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE): INDIANA ;;:(-:)1 Z!f!'rrv,"
f/;ji 'I "",,--::::::::> /c;\'0~,
TAX MAP PARCEL #: I. ", ((~,. ^, '",
I 11,/ "'vi/I"'"
Ii ...........0' ]/:,"""
PLUMBING CONTRAct R: ~ I '''::::: (-i'<'
~c ~\-U"'~" ~ 6' <'IJ",_ lf~',;:
Plumber's Indiana State License If'", va ;,? I If'
hich plumbing codes will be applied to the constru~ 0/
International Residential Code w/Indiana Amend~
o Uniform Plumbing Code wI Indiana Amendments
TYPE F CONSTRUCTION:
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
r:zr: RESIDENTIAL (For
Additions. Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split,
Y .~
Y~
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDITION(S)
Ii( RE~DEL
1 Basement Finish onl
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
Manufactured
Trusses:
_Y~
/Y_N
PHONE:
3\ d
FAX:
Sump Pump:
enY:
STATE:
BEST METHOD OF CONTACT:
PHONE:
FAX:
CTIY:
STATE:
\
SECTION:
ZONING,
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSP^,9E" 0 POST & BEAM ~IER
o SLAB ~ BASEMENT (WALKOLIT:_Y /~)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction conunences within 180
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 permits 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" (Z-
289) a 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
kitche 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
Occup cyhas been issued by the artment of Conununity Services, Carmel, Indiana.
OFFICE USE ONLY,
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Print
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\b-l\~-Ob
Date
Filing Fees:
Base Inspections:
Cert. of Occupancy:
INSPECTIONS REQUIRED:
Under Slab
Upper Footing
~g~
Lower Footing
Meter Ba"<3
Site
P.R.I.F.:
# Chargee Re-
Reviews
Addi~onal Fees
S:Permlts/formS/ILP RESIDENTIAL
(Date)