HomeMy WebLinkAbout06120082 Application
City of Carmel/Clay Township Permit#: ObI :J.oD&1-
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
PROVIDE
STREET ADDRESS:
PHONE:
FAX:
CITY:
d31'
~-LvZIP:
BEST METHOD OF CONTACT:
C -vn:?l
FAX:
CITY: STATE: ZIP:
SEmON: ZONING:
S /
SQUARE
'3 FOOTAGE'
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):
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:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
FOUNDATION TYPE: 'iheck'all th-i'~ apl!ly for ~
construction area f)"VYU.<2..Vl.$Le')I W / ~
o CRAWLSPACE rRU~ BEAM _PIER
L.E^SSCl. ~ ~~a@rr: Y cNl\
For Single Family and Two Family dwellings, additions, remodels, and/or accessoG~ p. 5' dt> . c ~~smmences within 180
days of the date of issuance of the building pennit, and must be completed (Certificate of c i~s~~) 1IIl~ fPc~,~~.,.'ll'lW' ce date. CI~s I
structure pennits are subject to the General Administrative Rules of the State of InAiiil~G15 f1~h'd:i1g 'w.r~StJti.'Jor beginning and
completingcons~n'. _..aME.lI CLJ\l .'. '\,
I, the undersigned, agree that any construction, reconstruction, enlargement, relocati~t'f\ltQi,~tYUctu~\lh.~Ahange in the use ofhmd or structures
requested by this application will comply with, and conform to, all applicable laws of tl're'state of Indiana; and IN \;lMiM~t)rdinance 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 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 Certificateo!
u cy has been issue the Department of Community Services, Carmel, Indiana.
S;gn re.fOwne'.' A"thori,ed A:nt ~. (~_1'11 C.e "St=ev ArlOU I ~
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDIN"
o DETACHED GARAGF
o ATTACHED GARAG
o DEMOUTlON
Early Release
Permit:
PROJECT INFORMATION:
Manufactured
Trusses:
~~
Lot Split:
_Y -.6
y --G)
Sump Pump:
WJJxJ.,f
TAX MA? PARCEL #:
L,__
PL~~BING CONTRACTOR:
~ rT S~ .Inc..
PI~bpS ;o;;;)iC;Se r
hich plumbing codes will be applied to the construction:
ntemational Residential Code w/Indiana Amendments
o Uniform Plumbing Code w/lndiana Amendments
/ ~ Ie-I/O,
Date r
OFFICE USE ONLY: ******************************************************
Fiiing Fees:
Base Inspections:
INSPECTIONS REQUIRED:
C ,/';,1
-2 'J?, ..) {/
,
'-.3 ..--;/
.s .)1/
# Charged Re-
Reviews
Cert, of Occupancy:
P.R.I.F.:
S:Permits/forms!IlP RESIDENTIAL
Additional Fees