HomeMy WebLinkAbout07010034 Application
City of Carmel/Clay Township Permit #: 01/)1 cJ1J31
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, l!r. Two Family: New Structures, Additions, Remodels, l!r. Accessory Structures
(
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
l!r. PROJECT
INFO:
SEWER UTIUTY 1\..
PROVIDER: L...-
NAME:
STREET ADDRESS:
LOT #:
I
SUBDIVISION NAME:
ADDRESS OF CONSTRUCTION:
PHONE:
FA)(:
WATER UTIUTY 1
PROVIDER:
cm:
STATE:
ZIP:
SECTION:
ZONING:
SQUARE
FOOTAGE:
NAME OF UTIUTY 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:
~NGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release /'
Permit: Y v N
Lot Split: Y 0
TYPE OF IMPROVEMENT:
)!t NEW STRUCTURE
o ROOM ADDlTION(S)
o PORCH ADDmON(S)
o DECK ADDlTION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
Sump Pump:
y~
v-Y' N
i:l'
"1
;/ iI
1111J'
II,I!
~I '<' ;.,/
of L_____ liO/
Plumber's Indiana State' License #: --.J
~COr~----- ..
Which plumbing codes will be applied to the construction:
~ntemational Residential Code w/Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE
o SLAB
For Single Family and Two Fantily dwellings, additions, remodels, and/or accessory st~c!!Ite~~~~ GQ .:' , ns~mmences within IBO
days of the date of issuance of the building pennit, and must be completed (Cert~~cy ~.~Yr.Q.t~S\ib~~r?rrlhe-i~su,ance date. Class I
structure permits are subject to the General Administrative Rules of the State of h~n~em=W'~~J~~Y.th~?J~Fwn~time fr~. es for beginning and
completingconsffil'c't'i\;n, O~.. \a\e.,an" ~,:Cl\J\CE.~..
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or a!terat~o . ,<1#ft\G\P.~\tJ~dhL.ngt'.!t!l~i}\t, ~JM~r structures
requested by this application will comply with, and conform to all applicable laws of th~Ilin' a,'itflWrHJ Olfip8P~ai\cuNl:i.ftMfIh'c!iana -1993~ (Z~
289) and amendments, adopted underauthori .. 6-7 et seq, e Assemblyoft~ ~dP~~~m cts~atorythereto. Jfurthercertifythatonly
kitchen, bath, and floor drains are conn to the sanitary sewer. I further tify th . oYfuc~on wil\n~ANAr occupied until a Certificate of
Occupanc has been issue b the e artment of Conununity Services, Cann I, Indiana. . .
I. :(;U ~-S-07
Date
Upper Footing
INSPECTIONS REQUIRED:
********************************
c
er,Footing
Filing Fees:
Base Inspections:
Cert. of Occupancy:
P.R.I.F.:
Meter Base Final
I
ReviewedjApp eved: Dept. of Community Services
S:Permits!FormS/ILP RESIDENTIAL
(Date)
# Charged Re'
Reviews
Additional Fees
j'C'
Date