HomeMy WebLinkAbout06110004 Application
City of Carmel/Clay Township Permit #: CXR II ft1J{} if
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM AODITION(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATIACHED GARAGE
o DEMOLmON ,
PROJECT INFORMATION: FOUNDATION TYPE: Check all t at ply for the n~~
~ construction area ~tiJ
Early Release Manufactured /'\
Permit: _Y Trusses: -----'.;I" _N 0 CRAW ACE 0 POST & BEAM PIER
Lot Split: _Y ~\O~~mp Pump: #_N 0 SLAB X BASEMENT (WALKOUT:_Y---0:>
For Singl,:~:vp.tlv~i\.to ~y:H wel\irl~s, a di~9'Y' {~. and/or accessory structures, this permit is valid only if construction commences within ISO
days ofall~rt/fi~~~e ~f\t~'(buj.!awg ~~~:'and~'i:tstb~ completed (Certifi~ate of Occupancy issued) wi,thin 18 .mo~ths .of the issuance dat.e. SIass I
structure ~~bjett'to"ilie Ge~~Lat:AJ\~S1PatIVe Rules of the State of Indiana (See 675 lAC 12) regardmg explratlon tune frames for begmm?g and
. 'sapO~ re~O ,~~',"':"_>\\dWO:) 0\ pelqnScompletingc~nstruction. . . !
I, the underSIgned, agr,;~,tIJ<tfi!PYI~truttlon, recon~~~~~ement, relocatIOn, or alteratIOn of a structure, or any change m the use of land or structures
requested by$hl.91wll~afron."YQ!~1wnp'Iy.,Wt9CarlPQofciFriVtd, a'rtpplicable laws of the State of Indiana, and the ~Zoning Ordinance of Cannel Indiana - 1993" (Z-
289) and ameR~h~Ca4OPud,una!t~uthority of LC. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath,\i'h"a'rtoor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
ancyhas been iss~ed by the Depart~ent of Community seC}- ,annel, Indiana. ...
_111(1e ~wItnOU'(' /1J)3/ /0 .Co
S' ture of Owner or Authorized Agent 'nt Date
BUILDER
OF
RECORD:
PROPERTY
OWNER:
c...
NvUiR
STREET ADDRESS:
LOCATION
&. PROJECT
INFO:
N CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
D/OR COUNn WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PHONE:
FAX:
61s-"?3JrI
FAX:
cm:
STATE:
ZIP:
SEtON:
Z;Ii:
SQUARE
FOOTAGE;%34
ESTIMATED COST OF CONSTR~ON:
(EXCLUDING LAND VALUE). t'd-CO r;, 5 '8
NOV - 1 2006
~ ;
____._.1
-at:>
PLUMBING CONTRACTOR:
HM7MYJ~~ f/lL/
Plumber's Indiana tate License #:
(JJJ/~ fl) /
Which plumbing codes will be applied to the construction:
~temational Residential Code wI Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
OFFICEUSEONLY:*********************************************************************************
INSPECTIONS REQUIRED: e Filing Fees: !5 ~ . ~
-- III U> Base Inspections. _ '7 _' 0 # Charged Re-
pper Footing ower Footin Under Slab . 53 "" ReViews
~. ~ Cert. of Occupancy: . ,W 0
~ ~ P.R.I.F.: J~4? I., 0 0 Additional Fees
/ I'
C (~~O]Al;~: 4 J, /5 'fif. 10
Reviewed/Ap roved: Dept.ofCommunityServices (Date) ~~~
S:Permlts/Forms/ILP RESIDEI'fllAL Fee Recetved by: ...- Date