HomeMy WebLinkAbout07020125 Application
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BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
8r. PROJECT
INFO:
City of Carmel/Clay Township Permit #D70aDJ :<5
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, 8r. Two Family: New Structures, Additions, Remodels, 8r. Accessory Structures
CITY:
50/.. dOh FAX: 57S-JXl5
CAEJt1EL srAj'N ~!OIJ,:2-
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SI
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FAX:
STATE:
ZIP:
STREETADDRE~~lrlrI
CITY,
SEmON:
ZONINGS -1
SQUARE 58
FOOTAGE: ~
ESTIMATED COST OF CONSTRUcnON:
(EXCLUDING lAND VALUE) j
A,J- ~LLPfPLOI2
TAX MAP PARCEL #:
- q-ICf-DO~O(-OD7~(;o
TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
if NEW STRUCTURE _HAM M ~O~ l / fJ c..-
O ROOM ADDITION(S) Plumber's Indiana State License #:
o PORCH ADDmON(S) C. f'I I 0000 I 0 I
o DECK ADDmON(S) X
o REMOBDEL t F" "h I Which. plumbing codes will be applied to the construction:
asemen InIS on v-........ .-/"
o ACCESSORY BUILDIW' ,~ International Residential COde w/Indiana Amendments
o DETACHED GARAGE! \] Uniform Plumbing Code w/Indiana Amendments
o ATTACHED GARAGE
o DEMOLmON
WATER UTIlITY
PROVIDER:
NAME OF UTILITY EX VATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNlY WELL AND/OR SEPTIC PERMIT ,'5 (IF APPUCABLE),
FLOOD ZONE AREA DESIGNATION(S)
FOR nus PROPERTY:
TYPE OF CONSTRUCTION:
IZ1'" SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
(Check all that apply for the new
FUll- ())'J elfJ ISH 6:.0
o CRAWLSPACE 0 POST & _", BEAM . ; PIER
o SLAB ~SEMENT(w;;,Gz9Jr:, '~Y. -,iN)"" \
- '. ,:-:- , ........-..-- I ,
For Smgle Farmly and Two Family dwellIngs, additions, ~~ gcti~m~~M~iHi4d only if co~stru~tion commences w4h1:n 180 \
days of the date of issuance of the bUlldmg pernut, and rrSulb~Et~~r.ti.QcA~ of c'iup'1cl.~ 't5'sllC~61Qlthm 18 mori~h'~ of the IsWant}e ~td..\~U.ss I \
structure pennits are subject to the General Adnurustratlve Rules ~f&~~f~ ot~'d.~a ~ 61~ rAlg~g exprratlOn tune ~~ far begmnmg and \
come.ltt!lifdjll~6fi!i COdes \\\ \\ --/'
I, the underSigned, agree that any constructIon, reconstructJ(Q~;:geQht, @;~/W ~~~FfJ.l{~or any chang~\l~ t~e use of la_nd or stniC'rures _
requested by thIS applicanon wIll comply With, and confo~'V'PlK:$1~~~"Y~ e'S(at:e" btlrtdi~r;.rn.dfd\ottzSmg Ordmance of Carmel Indiana - 1993" (Z' -----
289) and amendments, adopted under authonty of I C 36'7 et seq, G'W1rra~t - t1J S'akAf'Jhdj@-\AAAp:ij.Ai:lamendacolythereto r furthe~ c;:ertify thac ~nly
kitchen, bath, and floor drams are connected to the samtary sewer I further cerufMlf:hal:ltA-e,QQ{lstructlon ~hll"d'llM\ised or occuple~_ntiI a Certificate of
Occupancy has been issued by the Dep ent of Community Services, Carmef,'I1.~Mil~ ~J-\ \,..':.-~
~MtJG &lEPrtee.oU 2-[ 10 1
re of OWner or Auth rized Agent
"XiI
,
"
/ FOUNDATION TYPE:
construction area)
Early Release
Permit:
PROJECT INFORMATION:
Manufactured
Trusses:
~_N
./Y _N
'"
\\
Lot Split:
_Y~
_Y_N
Sump Pump:
Print
Date
, Charged Re-
ReViews
P.R.LF.:
Additional Fees
Reviewed/Approved: Dept. of Community Services (Dale)
S:PermitsjFormS/ILP RESIDENTIAL
Fee ReceIved by:
Date