HomeMy WebLinkAbout06110010 Application
City of Carmel/Clay Township Permit #0f0L1a.2JJ2-
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:
PHONE:
FAX:
-73/8'
STATE:
IN
ZIP:
'W
BEST METHOD OF CONTACT:
PHONE:
FAX:
CITY:
C
STATE:
I
ZIP:
4
S ,
SQUARE
FOOTAGE: 8
3
SECTION:
3
ZONING:
ESTIMATED COST OF CON51iUcnON:
(EXCLUDING LAND VALUE) ~ ;;l;;U..
'..-=#?_aJ:7j (Dod1
" ',I! '(;-;; I'~ ~. ___'
i ; U II' r---:'! ~ I fi';' P ~-;:;::: >_
/1 / ~ U I...'l'--I_
1/ r, ( 'l 'i:', ;'.--
I" ,I L!:._;
PLUMBING C. ONTRACTOR: ,I IJ /I! -{I / !
P . I lj f 1/1 I
E.S I I L__ III/I
Plumber's Indiana State LiCe!!~ 1JlJ;'
10171 '7 ------~
Whi.,9fplumbing codes will be applied to the construction:
ot International Residential Code wI Indiana Amendments
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); ANDIOR COUNTY WELL ANDiOR SEPl1C PERMIT #'S (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATlON(S) X (, ~ \
FOR THIS PROPERlY: /.U\Shctdeo' )
TYPE OF IMPROVEMENT:
~ NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
ON:
TYPE OF CONSTRU
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions, Remodels. Etc.)
Early Release
Permit:
PROJECT INFORMATION:
_Y~
_YXN
Manufactured
Trusses:
Sump Pump:
...&_N
1Y_N
Lot Split:
J"b
TAX MAP PARCEL #:
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWl5PA~ 0 POST & BEAM _~R
o SLAB r>/ BASEMENT (WALKOUT: Y v'N)
For Single Family and Two RE in s. [d4itlOn~r!m. ~'~\mi6My structures, this permit is valid only:if construction commences within ISO
days of the date of issuanc@>j~bbi'ltliii"g:p"fnllit?,~tl'muW Ii;" cQJllP1eted (Certificate of Occupancy issued) within IS months of the issuance date. Class I
structure permits are subject to the Gt.n,e~.h~':~S:trktl~ QbrtRe Stjl~gfwdiana (See 675 lAC 12) regarding expiration time frames for beginning and
. .- <;: r:nM~AUNITY ~~~lg~truction. . .
I, the undersI~ed, ag.ree ~hat ~y:d?~tQtlOIT;"2:..ec~n.Hrticp~\ eW~q:qeW^I/lllqqltJ41l~r alteratlo~ of a structure, or ~ny cha~ge m the use of land. or structu:es
requested by thLS apphcatlo~~o~r-~\'ti14'fPiiw ko; 1.ill-!lpplkMl1~ l'alJs~r die State of IndIana, and the "Zonmg Ordmance of Carmel IndIana - 1993 (Z'
289) and amendments, adop~Jn~e~?uthorjty of I.~ fP\1 n M~p.peneral 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 shh~Wer. I further certify that the construction will not be used or occupied until a Certificate of
Occupancy has been issued by the Department of Conununity Services, Carmel, Indiana.
. ,
loR\ A, ~'IR'bSOr-}G-J.j.oU;AII::
Print
IIJdck
Date'
I
Reviewed/Appro Dept. of Community Services (Date)
S:Permlts/Forms/llP RESIDENTIAL
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