HomeMy WebLinkAbout06110123 Application
City of Carmell Clay Township Jft 05 Permit #:()~ II () I ;J.3
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICA'FION
,
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
I
FAX 8'1
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
SEWER UTIlITY
PROVIDER:C
NAME:
!)
STREET ADDRESS:
LOT #:
/I
.:lco
J
SUBDIVISION NAME:
ADDRESS OF CONSTRUCTION:
:)5 PA
WATER UTIUTY
PROVIDER: C
PHONE:
CITY:
STATE:
I
ZIP:
.s
I
.n 8'""": r.:.1 r'~~-"'':.,-:.......
PHONE:
CITY:
IN'
SQUARE
FOOTAGE:
//,,9
ESTIMATED COST OF CON~. UCTION:
(EXCLUOING LAND VALUE) po 39.i)().
NAME OF UTIUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
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:
M RESIDENTIAL (For
Additions. Remodels. Etc.)
Early Release
Permit:
PROJECT INFORMATION:
_Y~
_Y~N
Lot Split:
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o flECK ADDITION(S)
00 REM9DEL
L Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
Sump Pump:
~_N
~Y_N
PLUMBING CONTRACTOR:
'pAul f S,.ilnl
Plumber's Indiana State License #:
101 '1'77
Whi?plumbing codes will be applied to the construction:
~ International Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
~ :::LS:l:ASE~;_~:~K9U[:B~~:\~R
_.---- _, I; ',.__- \
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pernyt isvali?:(;cl:yiff~iistn'.~~J6~ c~irifi.i~A,~.es\1~hin 180
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issu~a),~t!i.in\I~moiii:hsOf the issuance_'d.at~. \<;:Iass I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding~expiration time frames for ~J:lg and
completing construction. ".\\ ))\ 1 f)\\,}O \\\.Jl\-
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structur,e;-.q,t\iI,1y ch'\n-~ tte ute o~land or St1itcture~
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and th~tZonln'g orcMJ.'ln'ce of Carmel Indiana.=<\1993" (Z-
289) and amendments, adopted under authority of I.C 36-7 et seq, General Assembly of the State of Indiana, and all1\.cts'amendatory thereto...+furtlitl certify that10nly
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will nJt'B,e h1~d or. occupied-until a Certif1ca(e..oF~
o cupancyhas be~n issued by the Departme~t of Community Services, Cannel. Indiana. \... \-- .~------
Loll.; A. P>;RbSlINrT- J./F1\l/:Nf' \ ________.--- --- IJln)Dfe.
Print Date
I
I
OFFICE USE ONLY: ******************************~~*********************~3***J{;*******************
INSPECTIONS REQUIRED: FIling Fees: / ~ ,
/J/
(/!,-'3
Upper Footing
~
Base Inspections:
(If)
>1J
# Charged Re-
Reviews
Lower Footing Under Slab
Meter Base 0:al
Cert. of Occupancy:
Additional Fees
P.R.I.F.:
,/b~A~"j'dO
. of Community Services
DENllAL
Date