HomeMy WebLinkAbout06100090 Application
City of Carmel/Clay Township Permit #ObICiX)CtO
" 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:
SEWER lJTILITY
PROVIDER:
NAME:
M , CAr",-eJ
,,5-\('<..><::__:\ ~ ~
STREET ADDRESS:
12>i)-"1'5""
'<k
BUkl;;JMAIl ADDRESS:+
NAME:
DOt 'b.:,1acc:.
STREET ADDRESS: . . I
\ { ~r-\L..\iiei.U?-'r.
PHONE:
"6\1' 9
CITY:
FAX:
-0 I (, BLf 6-?;''ILC
STATE:
Ur
ZIP:
I/O
BEST METHOD OF CONTACT:
~rvc.+1
FAX:
LOT #:
CITY: I
r t'J-te..-
STATE:
'::DO
ZIP:
YloOb ).
~
SECTION:
ZONING:
(4"
RELEASED FOR CONSTRU
Sub' , C
~had~
TYPE OF IMPROVEMENT:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
IV RESIDENTIAL (For
Additions. Remodels. Etc.)
o NEW STRUCTURE
o ..-ROOM ADDITION(S)
10" PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
Early Release
Permit:
PROJECT INFORMATION:
#/ Manufactured
y V N. Trusses:
_Y N Sump Pump:
~~~
Lot Split:
SQUARE
F. 1: GE:
5r>
PLUMBING CONT . 'I
0C1 , 2. 2.006
Plumber's Indiana S
Which plumbing codes wil be e construction:
o International Residential Code wI Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE
o POST &
BEAM _PIER
SLAB 0 BASEMENT (WALKOUT:_Y_N)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is valid only if construction commences 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 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" (Z'
289) and amendments, adopted under authority of I.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 Certi/icate of
Occupancy has been Issued b e Department of Community Services, Cannel, Indiana.
o;..a,",,:.6- ~~~ L-4t.Ub'":5
OFFICE USE ONLY: ****************************************************** *J*****~*****************
INSPECTIONS REQUIRED: CI~\ Filing Fees: / tL t.P .. /
~ ~. lOt-' Base Inspections: / (Q to .. 5"0 # Charged Re-
,,--Upper Footmg Lower Footmg Under Slab L" 3 ~O ReViews
~._.~-- Cert. of Occupancy: v ., .6
c::: Rough I;;") Meter Base ~ Site
C) ,
P.R.I.F.:
~
Date
Additional Fees
(Date)