HomeMy WebLinkAbout07030044 Application
City of Carmel/Clay Township Permit #:()?030041=
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
FAX:
PHONE:
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NAME:
BUILDER
OF
RECORD:
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I ZIP:
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STATE:
CITY:
STREET ADDRESS:
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BEST METHOD OF CONTACT:
BUILDER'S EMAIL ADDRESS:
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FAX:
PHONE:
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REI .t:: CITY: STATE:
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O;npli<ince lvi'h ~~CiiON':' : h.JN
of State and La :1, ~: rlegulations
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CITY OF CARME~~N/TY ~ERV!CES
I C~lED COST OF'C .
(EXCLUoING LAND VALUE)
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NAME:
PROPERTY
OWNER:
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ZIP:
STREET ADDREJ~:
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ZONING:
SUBDIVISION NAME:
LOT #:
LOCATION
& PROJECT
INFO:
51
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ADDRESS OF CONSTRUCITON:
-~no. S CeLk C1~T
SQUARE
FOOTAGE: \\0=
SEWER lJTILIlY /l WATER UlllfTY /J
PROVIDER: l..l a: PROVIDER: vax
NAME OF UTILITY EXCAV ON CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC OATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
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TAX MAP'PARCEL #:
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FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
PLUMBING CONTRACTOR:
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Plumber's Indiana State License #:
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TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
O/DECK ADDITION(S)
.l1!l RE~DEL
L Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
TYPE OF CONSTRUCTION:
e2l'" SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
_/ time:
~ RESIDENTIAL (For
Additions. Remodels. Etc.)
Which plumbing codes will be applied to the construction:
o )"temational Residential Code w/lndiana Amendments
r:rI' Uniform Plumbing Code wi Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST &' BEAM PIER
o SLAB ~ASEMENT (WALKOUT:_Y h)
PROJECT INFORMATION:
_Y "/N1f!J
LY_N
Manufactured
Trusses:
Sump Pump:
Early Release
Permit:
Lot Split:
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For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction conunences 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 LC. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kit \ en, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
OC 'Ptmcyhas been issued by the Department of Conununity Services, Carmel, Indiana.
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Print
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Date
: ******************************************************~******~*****************
FOlo F rJ, ::J . S U
INSPECTIONS REQUIRED: ling ees: I II rJ
U F t' L F t' Under Slab Base Inspections: / / I. v
pper 00 '"g ower 00 '"g ;,- :2. 0 ::: ()
.-w;. ~ ~,._ ~ Cert. of Occupancy: 2. .J ~
( ~.;~ MeterBase <.....~inal ~ P.R.I.F.: ~ ffl;
~ TAL: ::? {Ie?
Revlewed/Approv Dept. of Community Services _ ::;;;;~ /-f._
S,Poem;"!F",,,,"ILP RESIDENTIAL ~ ~" ~.
Fee Received by;
# Charged Re-
Reviews
Additional Fees
Date