HomeMy WebLinkAbout06110116 Application
City of Carmel/ Clay Township Permit #~
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:
SEWER UTILITY
PROVIDER:
NAME:
NAME:
STREET ADDRESS:
LOT#: q S
SUBDIVISION NAME:
gC(6 -tJ;)~t/
!:1J
FAX:
STATE:
ZIP:
SECTION:
ZONING:
ADDRESS OF CONSTRUCTION: '3
1\ -r () l . '\ WATER unUTY
G \ 10VV D PROVIDER:
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u 10JI1/LfJ/'t-I
U1XrM!
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY;
TYPE OF CONSTRUCTION:
'17{ SINGLE FAMILY
/2) TOWN HOME
o TWO FAMILY
# of 'units being
constructed at this
time:
o RESIOENTIAL (For
Additions. Remodels. Etc.1
Early Release
Permit:
PROJECT INFORMATION:
y~
yV;;-
TYPE OF IMPROVEMENT:
XNEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK AODmON(S)
o REMOOEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
Manufactured
Trusses:
Sump Pump:
v; N
VY-N
SQUARE
FOOTAGE:
ESTIMATED COST OF CONSTRumON:
(EXCLUDING LAND VALUE)
/.
:# 06110/6
NAME OF UTIlITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
For Single Family and Two Fam.ilL.~~~l ~tccessory structures, this permit is valid only if cons!XUc~ion c?~e~ces within ISO
days of the date Of.'. ~IHil!f~rmi~ 6i~ etea (Certificate of Occupancy issued) within 1.8 m. 9~th(~f the iss!lance date. Class I
structure permits ar s=~~sM~ of the State of Indiana (See 675 lAC 12) re~~~2-g ~pi~~t,~~n,.tJ~!le frames for be~ing and
Su I <::tme and LOC3 <>i::1=l~&gconstruction.. ..-" \,0.''' '.<>./. , '.'.
I, the undersigned, agree that anyQtM~~lilftIE~~~~~r~Pim.tion, or alteratlOn of a structure; ?f ~ny'change in the use of J~ or structures,
requested by this appli' . ~"-'fh, 0 ,~~JaQf"of the State of Indiana, and the "Zoning Ordinance of Carm~I,lh'dlana -.J99~;(Z'
289) and amendments,~-~ ~u.~" ,. . :t~q, ~neral Assembly'of the State of Indiana, and all Acts ~mende+Prn thireth-. IEurther ce::.9fy that'qnly
kitchen, bath, and flo~ G~Qt:C t t iw.~ewer. I further certify that the construction will n~t 1:'e)I,sed or~Jpied until a );.ertiEica. e of \.
Occu'Pancyh been M~Jd~by th ar f!Ommunity Services, Carmel, Indiana, \ \ \ \ \ \ -'" ...
\ " '
. rO"
Lot Split:
OFFICE USE ONLY: *******************************.~*******************7*J~*~******************
INSPECTIONS REQUIRED: Filing Fees: -' ;/ (J
. .' Base Inspections: '2 -? ;7 :;;z;
~ pper Footmg Lower Footm nder Slab . .
Cert of Occupancy: ') 3 . ,Jd
ough I FinalSlte' ./ J '7 ~
P.RJ.F.: / /0<- G /.--;jj
\\r~Q. M~ LL-?7-~ L-;~d~JA~:~' $;23 sri m
'ed/Appr~ved: Dept. of Community Services (Date) ~ ~~/G<------_.
\'ll1S/ILP RESIDENTIAL
Print
Fee Received by:
l\ \ 5\-
TAX MAP PARCEL #:
PLUMBING CONTRACTOta
. ~ ~ rtL'I-
Plumber's Indiana State License #:
JO~/109
Which plumbing codes will be applied to the construction:
o International Residential Code wI Indiana Amendments
~niform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 PeST & BEAM PIER
o SLAB BASEMENT (WALKOUT:~Y. ( N )
./
Oate
# Charged Re-
ReViews
Additional Fees
Date