HomeMy WebLinkAbout07030115 Application
City of Carmell Clay Township Permit #DfJD?:f) I) 5
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
OJ 10 '6'f1Q
FAX:
C( 16 ~fl6
~ Dewnve
~tqqDR~SS: . ~
PHONE:
'>1",<--
~ ~r
FLOOD ZONE AREA DESIGNATION
FOR THIS PROPERTY:
BUILDER'S EMAIl ADDRESS:
STREET ADDRESS:
~ z.:~ <(
LOT #: .
/59
5~ 6\-.
SUBDIVISION NAME:
\<< (S~
ct.
STATE:
ZIP:
PHO~EPT OF COM~~UNl"fY ~~VICES
cm:
,
wttl
INOI
SEmON:
IN
ESTIMATED COST OF CONSTRUCTION.
(EXCLUDING LAND VALUE)
TYPE OF CONSTRurnON:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
X: RESIDENTIAL (For
~/ditiOns. Remodels. Etc.)
~OJECT INFORMATION:
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
.J8l:. REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
Manufactured
Trusses:
c.----
Y N
Y~/
Y C~
- .-/
_Y_N
Sump Pump:
SEWER UTILITY WATER UTIlITY/_
PROVIDER: QVlDER: ltlf
NAME OF UTIUTY EXCAVATION CONTRACT ; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR CQUN1Y WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
Early Release
Permit:
Lot Split:
TAX MAP PARCEL #~ ~;
.. \
~ : r"",\ \
PLUMBING CONTRAcTOR:
:~.! \ .'.
,
1 ,
I' iil
i.)/\
,
i
,
_.----_...~.--_..'"
Plumt0"~iana Sta,~~~~~~~~~:
Which plumbing codes will be applied to the construction:
o International Residential Code wI Indiana Amendments
o 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 -R. BASEMENT (WALKOUT:_ Y ~N )
For Single Family and Two Family dwellings. additions, remodels, and/or accessory structures, this pennit is valid only if construction commences within 180
days of the date of issuance of the building pennit, 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 undersign d, a ee tha} y constructio reconstruction, enlargement, relocation, DC alteration of a structure, or any change in the use of land or structures
requested by this pplic tion will comply with, d conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana - 1993" (Z~
289) and amendm nts, a pted under authority 0 LC. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and or ns are connected to th samtary sewer I furthe~;{;~tl~~~;he construction Wlll not be used or occupied until a Ceralicate of
Occupancy has i ,u y the Departmen f Commumty Semee" ~a 6 '3) III 107
Slg.ature of Ow.e, 0' Age.t Pri.t / ~ Date
OFFICE USE ONLY: ************************************** *******************************************
INSPECTIONS REQUIRED: Filing Fees: ,/ 3 '3. .;> cI
. _ Base Inspections: J / 1_ d d # Charged Re-
Upper Footmg Lower Footmg Under Slab . ReViews
~ Cert of Occupancy: S3 :;id
~ M_'~ ~ ~p '~L;29J',;""-
Fee ReceIved by: Date