HomeMy WebLinkAbout06100177 Application
City of Carmel/Clay Township Permit #: dL1l00 1"11
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, 8< Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER NAME:
OF
RECORD:
FAX:
PROPERTY
OWNER:
LOCATION
8< PROJECT
INFO:
LOT#:
ZONING:
SQUARE II
FOOTAGE: '112'v
SEWER UTILITY
PROVIDER:
i~P
"
WATER UTll.TTY
PROVIDER:
ESTIMATED COST OF 'CONSTRUcrrON:
(EXCLUDING LAND VALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERM~ .' (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S) .. ~ c'U06
FOR THIS PROPERTY: ....._~
kl~
TAX MAP PARCEL #:
,
..... - 1'___
TYPE OF IMPROVEME.ttT: PLUMBING CONTRACTOR:
p NEW STRUCTURE ...-----.-_:~ '\ ~cO~
~OOM ADDITION(S) Plumber's Indiana State License #:
o PORCH ADDmON(S) t?--I Ob Pr'\OC.
o DECK ADDmON(S) J2.!.2.f"\ ::2
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
TYPE OF CONSTRUCTION:
.x SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions, Remodels. Etc.)
Which plumbing codes will be applied to the construction:
o International Residential Code w IIndiana Amendments
j2(Uniform Plumbing Code w/Indiana Amendments
For Single Fam~~je0bt~~?aWJtppp~~?dels, and/or accessory structures, this permit is valid only if construction commences within 180
days of the dateonssuan~t~\fQ1~~~,~ustJl~~pk:ted (Certificate of Occupancy issued) within 18 months of the issuance date, Class I
structure permits are suhi,ef)J;.rp. ~6~\:j~r~\U~ St,ate of Indian~ (See 675 lAC 12) regarding expiration time frames for beginning and
DEP I Ul"".. ,'" . Tn\NN5\"l1PmgconstructlOn.
I. the undersign~~ ~~AAM~/r~cdo'h':' In'argement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this~ic'a.t~lwirrcomply,wi~M4...t1<&fonn to, all applicable laws of the State of Indiana, and the ~Zoning Ordinance of Cannel Indiana - 1993" (2-
:289) and ameridments, adopted under autlI\~6rt~, ~6-7 et seq~ General Assembly of,the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains ar connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Cer . ca.te f
Occupanc been issued by e e of Community Services'5~I. Indiana. {;.' ~
. Pri:(Z)V'1L ~ ' '/
Manufactured "
N F~;~U#~
FOUNDATION TYPE: (Check all that apply for the new
construction area)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
o CRAWLSPACE
o
o POST &
BEAM
PIER
SLAB
ASEMENT (WALKOLIT:_ Y
N)
Date
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S-~_'SO
Filing Fees:
Base Inspections:
Cert. of Occupancy:
# Charged Re.
Reviews
P.R.I.F.:
Additional Fees
(Date)
fJ
S:Permlts/Forms{IlP RESIDENTIAL