HomeMy WebLinkAbout07020149 Application
City of Carmel/Clay Township Permit #: (j 7 (J '-D{lf:t
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory StrJctures
BUILDER NAME:
OF
RECORD:
PROPERTY
OWNER:
NAME:
STREET ADDRESS:
LOCATION
& PROJECT
INFO:
SEWER UTIliTY
PROVIDER:
PHONE:
FAX:
CITY:
STATE:
ZIP:
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I 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 CONSTRUCT ON:
SINGLE FAMILY
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:
Y./N
yV;;
&vo'$'(fJ'-q
y,. !i'.
TYPEOFIMPR~~T: o;oc; P ~ .,
~EW STRU~~ 7' <J,k' &IQI:,Q;/~
o ROOM ADDITION{ll) I'i C,,>"I>""~ a State 'ens: ,
o PORCH ADDmON(Sh'1A> V/v,r,1 0 t" 'L > ,- . ,
o DECK ADDITION(S) .}f.f;8 11(, l.'~ .", \ ,." :, 'II,
o REMOBDEL tF" h /lIiA~/WhjC .lio.:~II'~.L:'J~p'Pliedtothecollf'AJctl89''Ill "~I
_ asemen InIS OnrYV01.~:T&~~Q ',\ \ Ct:\l. ,J- ~ j 1 \
o ACCESSORY BUILDING , p,l'I.! I Resl~t\al ~ode wt!lldlana Amendme~ts- "
o DETACHED GARAGE ,ro.u.;.:?.G'b.... ,'\', ---.- \
o ATTACHED GARAGE Unlfo....'7ti'(i;"'oS' Co~~ w/Ind'!'na Amendments .)
o DEMOLITION FOUNDATIO~E: \Check all that apply fortti"-;';-';"-
construction area)' "__~~ ..-
Manufactured
Trusses:
~_N
_yVN
SLAB
o BASEMENT (WALKOUT:_Y_N)
o CRAWLSPACE
o POST &
BEAM _PIER
Sump Pump:
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 I.c. 36'7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drams are connected to the samtary sewer I further certify that the constructIOn will not be used or occupied until a C~Ttih ate of
Occu~ cyhasbeenlssu b t p entofCommurntySemm,Carme ndiana. , 1~1
Signature of Own r Print Date
OFfICEUSEONlY:*********************************************************************************
,SPECTIONS REQUIRED: Filing Fees: . tP 0:3 , ~g
U;--""'F t' U d SI Base Inspections: 2; 7, u
pper Fob 'ng n er r 0
Cert, of Occupancy: ~ ,=5 ,,5
P,R,[,F.: / ~I ,p () 0 Additional Fees
TOTAL: )p_ 1-1 I 9 S' ~ J 0
# Charged Re'
ReViews
(Date)
Reviewed/Approved: Dept. of Community Services
S:PermltsjFormsjIlP RESIDENTIAL
Fee Received by;
Date