HomeMy WebLinkAbout06100111 Application
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City of Carmel/Clay Township L~) Perm>>: (j(a(O Olll
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Fa iI llr. T Family: New Structures, Additions, Remodels, llr. Accessory Structures
Shannon Hinshaw
n e v.
Indiana olis
BUIlD~OI'\e AM<;;.e06-2941 fax 317-842-3389
BUILDER of
RECORD:
NAME
STREET ADORE
PROPERTY
OWNER:
~E
STREET ADDRESS
LOCATION
llr. PROJECT
INFO:
SEWER lJTIlITY /) WATER UTILITY /Y/1 J, 1'1/7 n I
PROVIDER: L.- PROVIDER: CU/U / (.,LA-
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR (OUNn WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
)iir' TOWN HOME
o TWO FAMILY
# of units:
fiL MULTI-FAMILY ,fA.J
# of Units:~
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
~
o
o
o
o
o
o
NEW STRUCTURE
ROOM ADDITION(S)
PORCH ADDITION(S)
REMODEL
ACCESSORY BUILDING
DETACHED GARAGE
ATTACHED GARAGE
DEMOLITION
PROJECT INFORMATION:
Early Release
Permit:
PHONE
FAX
m
ZIP
STATE
BEST METHOD OF CONTACT:
PHONE
FAX
cm
STATE
ZIP
SECTION
- /
rtJ 4 u()3:J-
ZONING:
SQUARE il) 74 C-
FOOTAGE:.?) J
: /40; 340
rtLrYLW2--h~~
t'~~
PLULJfjNG CONTRACTOR:
T L/rJ IJlJjJ,
Plumber's Indiana State License #:
!():).O(}!J S'7
Which plumbing codes will be applied to the construction:
~ International Residential Code w/Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
^ Manufactured X FOUNDATION TYPE: (Check all that apply for the new
Y N Y N construction area)
Trusses:
- ---::T - L 0 CRAWLSPACE 0 POST & BEAM ~
Lot Split: _Y ~N Sump Pump: _Y N~LAB O__BASEMENT, \ '
Does any part o....1m ..............I--""_IiFlriOrt.d;.signation"area: _Y ~N'-i~ Ie, ~ALKQLrr:---:-'Y:~N
.n~r"\;;7tT1::j~'1i!:I,.rroU'lC1TV ,,_\\r-_\_/ _- )1'1"
For Single Family ~H~gfPEng9rrw~im~~!W~\[1~1~.r~9tid!iHV?ill&/or accessory structures, this P~~~i~'~~';~iid only if construct~on J~~ni~ces
. within 180 days of the dateC0t SiatBce6rr~~_~..pett:n_it, a~d r::ust be c~mpleted (Certificate of Oc~~pancy issued). ~hie"j~\JIl~nt~s, oJ fh~
issuance date, ClasO~fl'qt'OlPe~,' 1~'!"ft., ee,. inistranv,C Rules of the State of\lndiaIia (S~~j!; lAC 12) regardmg ~,rrahon
.' . t)Jne- I~~~:S . r ep_w~and completing construction. \ \ \ \ \ \ __,...........,J \
I, the undersigneclG1IY:Qiin~L~:ir~ctfi, fi,illd"E: relo~atlOn, or alteration of a str~~~ul6\or ro:'y~ange..in.th~se of land or \\
structures requested by thIS applIcatIOn "fN0~MYiith, and conform to, all applrcable laws of the State of IIldiana,\md tne Zonmg Ordinance oLCarmcl
Indiana -1993" (Z-289) and amendments, aaopted'i.incter authority of l.c. 36~7 et seq, General Assembly of thelState of Indiana, and all.Acts-arne;datory
thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I furthe~y.t'hat.t~nstruction will not be
use .or occupied until a rtj[jca.te of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
W . r; ~jl!/}Al;JON /-I1AISH/JJAl j[)- /0- O/fJ
Sig ature f Owner r Aut oriz d Ag t Print Date
# Charged Re-
Reviews
Base Inspections:
Cert. of Occupancy:
P,R.I.F,:
Additional Fees