HomeMy WebLinkAbout06100162 Application
,
I
City of Carmel/Clay Township Permit #: tJhloO I (f);{
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, 8< Two Family: New Structures, Additions, Remodels, 8< Accessory Structures
BUILDER of NAME PHONE FAX
RECORD: S T
STREET ADDRESS cm STATE ZIP
BUILDER'S EMAIL ADDRESS BEST METHOD OF CONTACT:
PROPERTY NAM~ PHONE FAX
OWNER: . , -SD\.sJ. - d-/;}8
STREET ADDRESS S .- Q0, cm c.o-r CV\ e. \ STATE -::TJ2J ZIP '-I UG~
13~ c:Me1 ..sO~
LOCATION
8< PROJECT
INFO:
lOT #
SUBDIVISION NAME
SECTION
ZONING:
SQUARE
FOOTAGE:
I
/ 0<90
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
NAME OF UTIUlY EXCAVATION CONTRACTOR; PLAN COMMISSION I SZA I SPW DOCKET
NUMBERS; TAC DATE(S}; AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TYPE OF CONSTRUCTION: t:'PE OF IMPROVEMENT:
)6 SINGLE FAMILY ~ 1.t{,W 0 NEW STRUCTURE
. '0 TOWN HOME w.J- 0 ROOM ADDITION(S)
o TWO FAMILY '\0 0 PORCH ADDITION(S)
# of units: liJlvJ^-1jitt REMODEL
o MULTI-FAMILY I 0 ACCESSORY BUILDING
# of Units: 0 DETACHED GARAGE
~ RESIDENTIAL (For 0 ATTACHED GARAGE
Additions, Remodels, Etc.) 0 DEMOLITION
PLUMBING CONTRACTOR:
~r's India~a State License #:
Which plumbing codes will be applied to the construction:
PROJECT INFORMATION:
Early Release
Permit:
o International Residential Code wI Indiana Amendments
o Uniform Plumbing Code wjIndiana Amendments
(Multi-Family Construction Code) ~,
:' <\7
(Check all that applyf<:lr the new
.' 'V'
DioST & B~
o :BAsEMENf:5
WALKOUT:_ Y--.+-N
''0
"
Manufactured FOUNDATION TYPE:
" ~ construction area)
_Y -4-N Trusses: _Y-#N
'V ""-L 0 CRAWLSPACE
Lot Split: _Y ~N Sump Pump: _ Y p-N 5.4 SLAB
Does any part of the property lie within a special Flood designation area: _Y
,
/
,
,
,
N
" ' I
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction comm~nces
within 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) withi~ 18 months of It he
issuance date. Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
~QtNmrfm' f'''lfSl'!rbeginning and complering consrrucrion. .
I, the undersigne h . st.. a, i<~i(~#.'ehiargement, relocation, or alteration of a structure, or any change in the use of land or,
structures requeste t . . '. h,tinrfcanfarm to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana -1993" (Z~ 289) and amendments, adapted under authority of LC 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
th eta. I further certify, t only kitchen, bath, and floor drains are connected to the sanitary sewer. 1 further certify that the construction will not be
se or occ~picd un a ertmcate of Occupanc lffi'issuea'by~Q~ artmem of Community Services, Catmel, Indiana. / h
IV ~l 0[0
Dati I
INSPECTIONS
Upper F!1.!lting
~ Meter Base
***************3****~*****************
/3 . ()
,
/ / / cO
,;?3...:"Cl
# Charged Re-
Reviews
P.R.l.F.:
~ I O~~~~
Reviewed/Appro ed: ept. of Community Services (Date)
S:PermitsjFormsjIlP RESIDENTIAL
t9/zrrjD~