HomeMy WebLinkAbout07010145 Application
City of Carmel/Clay Township Permit #:~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of NAME
RECORD:
BUILDER'S EMAIL ADDRESS
yY\e
PROPERTY NAME FAX
OWNER:
STREET ADDRESS STATE ZIP
LOCATION LOT # SECTION ZONING:
& PROJECT
INFO: ADDRESS OF CONSTRucnON SQUARE
FOOTAGE:
SEWER UTILITY WATER UTILITY
PROVIDER: r:.; PROVIDER:
,
NAME OF UTILITY EXCAVATION CONTRACTOR;,PLAN'c:OMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COU~l)';,~\~~S~~f?/O~~~PTIC PERMIT #'5 (IF APPLICABLE):
N R 50~c'''~V~~i- '\ PROVEMENT' ~'. MBING CONTRA
SINGLE FAt:lI~yif;f/~/ ':~ TRUcrURE . . t'41' .tS'~
TOW~HOM,~~,>/ ~. OM DDITIO~~: ,P ~ . na State Lice
TWOFAMILt/ '1- ~ . 0 ORCHI'I DITIO~~)'d".s'/&'!. ~q-" q
# of Unlts:,,\ ~~ ~'RE EL 0):' . €I 'Z " .
o MUL TI-FAMW0':\ ~ . 0 CESSORY BUILDING i ~,}'~!i'll'8.lJ'v~~ ~d to the construction:
# of Units" -\ ' // . f1,~'id.t!ta.I")o~
o RESIDENTIA' L'(F . / /' eJ DETACHED GARAGE a :-"'1Z:'vv' dill Indiana Amendments
or ',/ 0 ATTACHED GARAGE lAj;'~ /~ &s <IIi .
Additions, Rel1)odels, Etc.) 0 DEMOLITION 0 'tIl'l!!:l>~.r. i~~ew/I~naAmendments
\, ./ (Mul -. y n~ de)
PROJECT INFORMATION: 'VIAA: ~Q
, M f ct d / FOUNDATION TYP-I01V'8!ht:"& all that apply for the new
Early Release / T anu a ure V v N construction area) -'7/1)
Permit: - Y .J,.L-N russes: 3
. /. - - 0 CRAWLSPACE 0 POST & BEAM
Lot Split: _ Y -\,L.N S'ff'..P ~ump: Y _N 0 SLAB I ~ BASEMENT /
Does any part of the property lieS{i~~,!~:~ ktl'.!l!;i,," od designation area: Y WALKOUT: Y II'" N
For Single Family and Two Family dwellings, a~~~~i' an, r~,~~tructures. this p tmit is valid only if construction commences
within 180 days of the date of issuanP!i!Jti'rF.~ll(fl'ff!t~& f:n~llit'be S9,mp1e'ted'(l;'ertificate of Occupancy issued) within 18 months of the
issuance date. Class I structure per~ ~b li:~~nerarA.dministt~~iVi:l:.Ru1eJ>~'~ the State of Indiana (See 675 lAC 12) regarding expiration
i /' u rejf~es..ror'begin~ing a~c!~completing construction.
I, the undersigned, agree that any construction, reconstructlOn;.~nla.rg~me~[, reloe~ti,ml',...pFaJ~eration of a structure, or any change in the use of land or
structures requested by this application ......ill comply with, and c9~f,orm to, ill ~p'plicablc laws'of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana -1993" (Z- 289) and amendments, adopted under au"thodty:of LC. 36-7 et seq)G~neral;4ssembly of the State of Indiana, and all Acts amendatory
thereto. I further certify t at only kitchen, bath, and floor drains are c~n'nected to the sari'itiif-;ewer. I further certify that the construction will not be
used r occupied until 'rtificate of Occupancy has been Issued by the Department of CommunIty ServIces, Carmel, IndIana.
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lD) ~ '--4 rOQ
Print: 0
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:::tf.(/IDID I #
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Cate
P.R.I.F.:
OFFICE USE ONLY: ***********************************************
Filing Fees:
Base Inspections:
Cert. of Occupancy:
INSPE
der Slab
# Charged Re-
Reviews
Site
Additional Fees
J
Reviewed/Approved: Dept. of Community Services (Date)
S:PermitsjForms/ILP RESIDENTIAL