HomeMy WebLinkAbout07010132 Application
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City of Carmel/Clay Township Permit #: rJ ':;: g ,'i1.~
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:
""do..
PHONE:
FAX:
(.S-Y...j:<f/ t'..i"
"
STREET ADDRESS:
'or 7 ,{ 6' 1'1 aU .Il u
BUILDER'S EMAIl ADDRESS:
CIlY:
ZIP:
STATE~
J
6. IE
1,1
(::<.-
~E,ET~DRESS~
f;:u::Jo e'
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
LOT#:
SUBDIVISION NAME:
SECTlON:
ZONING:
SQUARE ' g-A/1
FOOTAGE: I UW
, fJ.
E MA COST OF CONSTRUCTION:
(EXCLUDING LAND VAL~~) ; i/
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUmY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
TYPE OF CONSTRUCTlON: TYPE OF IMPROVEMENT:
o SINGLEFAMILY 0 NEW STRl,IguRE)~
o TOWN HOME 0 1Ul~'1l"OI)mo~~
o TWO FAMILY "::O\ll;JCPOR'ck ADDmON(S)
# of units bein~.t::I>..St.O r Pc;9ECK~iil>IffON(Sl,..c
c~nstructe~Usw-" co\i"'P'\eJ~ ~~OD~l:\ :~\I:\<;-J.. "':,
time: '6'ec\ \0 .,.'e al'C ,Basement F,"lsh'pn~
o RESIDENTIAL mr ' 0\ S "", 'O,J'ACCESSORY BUIUltflG
Additions. Remodel,\:>lfc,J'" C\)'Q:; D~Abim GARAGE
O~ CpS-\\'@~'1\rr~C;"""D GARAGE
PROJECT INFORl(JtibQ~ ~'DBlIOttnON
Ear1y Release Manufactured
Permit: _Y _N Trusses:
Lot Split: _Y _N Sump Pump:
_Y_N
_Y_N
',t,
./4
I l... .
TAX MAP PARCEL #: . '7 '?r1a,
'- <20 01pA:C71
'~
PLUMBING CONTRACTOR:'.
"-',.
'"
.......
"' '-i "---...,1
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Plumber's Indiana State License #:
".
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Which plumbing codes will be applied to the construction:
o International 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 0 POST & BEAM _PIER
o SLAB ~ BASEMENT (WALKOUT:_Y_N )
For Single Family and Two Family dwellings, 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 permit, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure permits 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 "Zoning 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. r 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
occup~has been issued by the Department of Community Services, Carmel, I~diana.
s;.notu~~&....0~nt Priql/l6t, Ih()~Y)5dJ PIWflc/l!1/tvtl(,t1( Do(/9/07
OFFICE USE ONLY: *********************************************************************************
F'I' F /33 60
INSPECTIONS REQUIRED: ling ees: . r
U F t. L F. un6Jr Base Inspections: .5,5 , v c:J
pper 00 Ing ower ootlng
Cert, of Occupancy:
Rough In Meter Base Final Site
# Charged Re.
Reviews
Additional Fees
Dept. of Community Se
S:Permits/FormsjILP RESIDENTIAL
1
.00
Date