HomeMy WebLinkAbout07020163 Application
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City of Carmel/Clay Township Permit #:070 '2D.1103
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RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory StrJctures
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BUILDER
OF
RECORD:
PROPERTY FAX:
OWNER:
LOCATION
&. PROJECT
INFO:
STATE: ZIP:
SEmON:
sIN;
SEWER UTIY1f i
PROVIOER:W~
NAME OF UTIUTY EX VAllO NTRAcrOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
FLOOD ZONE AREA DESIGNAllON(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:
Lot Split:
~=$
TYPE OF IMPROVEMENT:
~EW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUIL"-
o DETACHED GAR'
o ATTACHED GAP
o DEMOLITION
Manufactured
Trusses:
Sump Pump:
E_N
~N
TAX MAP PAR~~
'-Cfl- -roc .;-': {)I..),C:CV
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PLMING CONTRACTO~:, < '
~qJ?1 '.r'J crSciirFS ffl~ 6 2n07!
Plumber's Indiana State License #: " '
iii \ j;iC'
{' P I (JOt) () J {)i 'f ,----.- ---
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Which plumbing codes will be a~plied to the construction:
~ntemational Residenti~1 Code-w/lntliana Amendn;en~- ..
o Uniform Plumbing Code wI Indiana Amendments
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FOUNDATION TYPE: (~eck all that apply f'}'" th_eJew
construction area 'i! 111l1sJW~ r a.l/.6<:?1h
o CRAW ACE 0 POST & _ BEAM _PIER
o SLAB 0 BASEMENT (WALKOUT:_Y
For Single Family and Two Family dwellings, additions, remodels, and/or accesso~' .~ GlaNa81FQlJ~l mmences within 180
days of the date of issuance of the building permit, and must be completed (Cer . c is ,u'ed X ~ \1h1~W'fl~tliU0n8uance date. qlass I
structure pennits are subject to the General Administrative Rules of the State of IrSlJDl_'baf~ !lel&ft11~\eelI8-b~ time frames for beginning and
completing construction. Of~tate ColiC L.OC~\ O~. 0 I
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alterati~ ?41Jc.l,1KWI:9,OJM-VT1\Iini1iDrt\1VtGEiitld or structures
requested by this application will comply with, and confonn to, all applicable laws of tht{)EfbTIAdI. na~nd ~hV"'2~n~ 6rQip.aJ:J.f'\{'lk JiQ.fQll.Itlllma - 1993" (Z-
289) and amendments, adopted under authority of r.c. 36~7 et seq, General Assembly oJ.t~r,.W;qdtA~lJ.-/tGWMatdry.tNel!lll~~Uher certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify twltlte-:cJrfsbMIOTI Willnt>fA.NA or occupied until a Certificate of
~OCy has been ;"ued by the Department of Conununity Sm,;ces, Carmel, !ndiana, IN.
CVVUi".JJ ;;;;{.J.IJ?>-if1.(YUr:i 9YJ'CJ' S~U;fr70U' c ;;)/~ /07
Signa re of Owner or Autho . Agent rint Date
OFFICEUSEONLY:********************************************************5i.'**********************
INSPECTIONS REQUIRED: Filing Fees: / ()O . 00
F t" - F t" ~U d Sl b Base Inspections: ;) '7/ ')0
pper 00 In 0 er 00 In9 n er a ,.- ()
Cert. of Occupancy: ..::, 3.5
P.R,I.F,: ! ,.} C/ 00 Additional Fees
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F~celved by:
Si
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Dept. of Community Services
S:Permits/formS/lLP RESIDENTIAL
# Charged Re.
Reviews
Date