HomeMy WebLinkAbout06120024 Application
City of Carmel/Clay Township \ Permit #DIo I ~oo~1f-
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, 8< Two Family: New Structures, Additions, Remodels, 8< Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
8< PROJECT
INFO:
SEWER UTILITY
PROVID .
NAME:
.....
PHONE:
FAX:
~\
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ZIP:
4("o~"2....
LOT #:
SUBDIVISION NAME:
NA.
-0
CITY:
C
STATE:
ADDRESS OF CONSTRUCTION:
220 ..:s
-\...
BEST METHOD OF CONTACT:
'" i-
PHONE:
""5\ -8n-c~'
CITY:
r- .
FAX:
:.\ - :.
STATE: ZIP:
~ ..1\00
SEmON:
ZONING:
=
<:::::::::'Rn~:~ ;~SQUARE i.....
. '; r' .. ...... FOOTAGET
,_., I
ESTIMATED COSTrOF1CONSTRUCTION:
(EXCLUDINGLAI1~VALUE) DEe - 6 2006
iq !i.
SC
ii! in
!j ill
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i
,
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NAME OF UTILITY CAVATlQN CONTRACTOR; PLAN COMMISSION I B / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUcnON: TYPE OF IMPROVEMENT:
o SINGLE FAMILY I/if4,NEW STRUCTURE
o T~\&I\I !:LOME 0 ROOM ADDITION(S)
o TiIiI/;Jf.tM~8Eq FOR CONS:~L90RCH~DDITION(S)
SfllJ!f,~~!~e~~~Hance with '".IPoPEc:K'ADDITION(S)
c.onstr~'ffllit'ails ~, ~,'. 9-:,REMODEL
\:irp..e: a ,e and Loco! \.''-'''4f':S. Basement Finish only
o lfeSll:lHNl:1iiUO@MMUNITY ::PT,,\~E~SORYBUILDING
OIiJi1iti(lJf- ~lW",EtI:.).L "J 0 ,,!>,IiT~CHED GARAGE
t::L. f.\,; ,', I G' 'ATTACIlEO GARAGE
PROJECT INFORMAWbW:\NA ~ DEMOLITION
Early Release
Permit:
Lot Split:
_Y_N
_Y_N
Manufactured
Trusses:
Sump Pump:
_Y_N
_Y_N
,.~--.<::::::o ....
MAP PARCEL.#:-.----- .........------j
-- 0 . Z.
PLUMBING CONTRACTOR:
N.tl>..
Plum be 's Indiana State License #:
_.
..~
.....\/t>..
Which Plumb(ng codes will be applied to the construction:
o International Residential Code w/Indiana Amendments
o Unifonn Plumbing Code w/lndiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM ",--PIER
o SLAB 0 BASEMENT (WALKOUT;_Y_N )
For Single Family and Two Family dwelhngs, additions, remodels, and/or accessory structures, this permit is valid only if construction commences within 180
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the ~ZDning Ordinance of Carmel Indiana - 1993" (Z'
289) and amendments, adopted under authority 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, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupancy h en i ed by the Department of Corrununity Services, Cannel. Indiana.
.:5'U!7I(U) A. I.;)AI2.d~_ r. P.
Print
1/ ~3/{f)(,
Date
Si lure 0 OWner or Authorized Agent
OFFICE USE ONLY: *********************************************************************************
Filing Fees: /'
Upper Footing
Rough In
INSPECTIONS REQUIRED:
Lower Footing un~
Meter Base Final ~
Base Inspections:
Cert, of Occupancy:
Charged Re.
O\~ii::.~
~ Additional Fees
Fee
I~
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