HomeMy WebLinkAbout07010036 Application
City of Carmel/Clay Township Permit #: 010 (fJ1J3(f'
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
&. PROJECT
INFO:
NAME:
STREET ADDRESS:
LOTI:
ID
PHONE:
FAX:
STATE:
ZIP:
SUBDIVISION
SEOlON:
ZONING:
ADDRESS OF CONSTRUCTION:
SQUARE
FOOTAGE:
41D~
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
SEWER UTILITY WATER UTILITY A h
PROVIDER: PROVIDER: V I. m
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):
TYPE OF IMPROVEMENT:
~ NEW STRUCTURE
o . ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
PROJECT INFORMATION: 0 DEMOLmON FOUNDATION TYPE: (Check all that apply for the new
v< g.... con~uction area)
Early Release ~ Manufactured -t' \.J en .JJ
Permit: _V _N Trusses: V N-< m 5- m 0 CRAWLSPACE 0 POST&_BEAM--1-P1ER
Lot Split: _V LN Sump Pump: V'v _N!fi ~ ~. [ii 0 SLAB ~ BASEMENT (WAlKOUT:_v-KN )
For Single Family and Two Family dwelhngs. additions, remodels, and/or ac~~ ~~um this permit is valid only if construction conunences wi~ 180
days of the date ofi"uaoce of the building permit, aod must be completed ~e . '<$e<\f ceupaocy '"ued) within 18 months of the issuaoce date. ~Iass I
structure pennits are subject to the General Administrative Rules of th ati:o d~S~75 lAC 12) regarding expiration time frames for beginning and
com' n8lctfl1l10
I, the undersigned, agree that any construction, reconstruction, enlargeme efoca~, 61:. a!ttdliJm of a structure, or any change in the use of land or structures
requested by this application will comply with, and conform to, all applica a~""""oMIi.e,S,Eai!o~diana, and the "Zoning Ordinance of Cannel Indiana - J993" (Z,
289) and amendments, adopted under authority of LC 36'7 et seq, General &e l~ tttJ S~t~Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, nd floor drams are co cred to the sanitary sewer. I furtht!fte . 'tija~902-ruction will not be used or occupied until a Certificate of
Occupancyh been '"ued by the >IT e Community Services, Carrr1i1 I&I~~ ~ ~
Print Date ~
TYPE OF CONSTRUCTION:
.JCf' SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
;
,
I
~,~, "1'
--11 j i i;'
Ii i. hi
"I' !~f
i it:;
'l" II; .11"',,
IJ \'';1 1/0,
PLUMBIN~1Q~-'--_-J - I
Plumber's I dlana tate l i.. 'It:
10/11
-i:hiCh lumbing codes will be applied to the construction:
International Residential Code w/Indiana Amendfents
Uniform Plumbing Code wI Indiana Amendments
0101103,:>
OFFICE USE ONLY: ******** *********************M~**gt:f5************* ***************************
SPECTIONS REQUIRED: ~r1l9Fee~ Z .;7)"7- &0
~~ ...:;2 "71. ...--iJ # Charged Re-
t. LF' . d SI b Base Inspections. / . :> .
1"9 o~o ng, n er a ReVIews
Rough In ~se' cert~. Of.occupancy: /' ~.~.:;o
... ~ P.R.I.F.. (/LIOn..! vv AddltionalFees
. ~2.JILTPJ~ II/(J',j ~ /5// .A5
ReViewed/Approved: Dept. of CommuniIy Services (Date) (fIV~ V V (({.-II'/'
S:Permits/FormS/IlP RESIDENTIAL
Fee Received by:
Date