HomeMy WebLinkAbout07030010 Application
City of Carmel! Clay Township Permit #: 010"300 1"0
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, lk Two Family: New Structures, Additions, Remodels, lk Accessory Structures
BUILDER
OF
RECORD:
FAX:
ZIP:
"<C">
r:i: I
."
PROPERTY
OWNER:
STREET ADDRESS:
80
LOCATION ~ SION. \-1E:
lk PROJECT 0" I I\JLo .p,~
INFO: AD3~roNVffiL~ lJ0
SEWER lJTIUTY f':^ f\ .I\AQ WATER UTILITY /"I, 1 /),f\^<::7
PROVIDER: ~ ~ \.Jt...L-.. PROVIDER: ~ ~ \C:.. "---
m(o~
SQUARE
FOOTAGE:"'jil
ESTIMATED COST OF CONSTRUCTION: _ '"
(EXCLUDING LAND VALUE) 2: OC.::n..J
NAME OF lJTlLITY EXCAVATION CONTRAcrOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S): AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S) _ "''' ';'l
FOR THIS PROP_~~~':-'~-;:;n 0: ,j \ ;..... \ r\\ \,
TYPE 0 NsT I GrIO - :lSo..~fypfo " I' ,I ROVEMENT:
,'i ilr--- II \ 1\
SINGLE:~~J'1I~ YON fljRUCTURE
TOWN H.Q~~ \ "R 1 2.0{J1J Ril. M, DDITION(S)
TWO FAM~LYi \ UI\ - D. RcH DITION(S)
# of JnitS being. D' DITION<:!)
const.:uCtild~i REMOD yv\6l.D~tm
time: ~ B ment Finish only Ie plumbing codes will be applied to the construction: I
o RESIDENTIAL (For __ CCESSORY BUILDING 0 International Residential Code wI Indiana Amendments
AdditionJrRe1l'IoiIels. Etc.) 0 DETACHED GARAGE
o ATTACHED GARAGE 0 Unifonn Plumbing Code w/Indiana Amendments
PROJECT INFORMATION: 0 DEMOLITION FOUNDATION TYPE: (Check all that apply for the 'new
a!," ./' ./ construction area)
Early Release /' __ Manufactured r
Permit: ~Y ~y Trusses: Yy -rNN '
Lot Split: _Y _N Sump Pump: /N
TAX MAP PARCEL #:
PLUMBING CONTRACTOR: ~
Plumber's Indiana State License #, A--
o CRAWLSPACE 0 POST & BEAM ~
o SLAB ~ALKOUT:_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 confonn to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Cannel 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, ba , nd floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupan h bee issue bytheDepartmentoICOmmUnitysern=r~ DaM.p 3ft I'D!
o Owner or Authorized Agent Print Date
OFFICEUSEONLY:***********************************************************~~********************
F'!' F / '~ . tJ
INSPECTIONS REQUIRED: ling ees: / ? )
Base Inspections: / / / 00
Cert. of Occupancy: ' 'f]. 50
Lower Footing Under Slab
Meter Base ~ .Y
# Charged Re-
Reviews
Upper Footing
~
P.R.I.F,:
Additional Fees
Reviewed