HomeMy WebLinkAbout04120053 Application
City of Carmel/Clay Township permit#:()4r2tJ~.3
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of NAME
RECORD:
[34(;-tl
PROPERTY
OWNER:
NAME
PHONE
FAX
LOT# .
STATE
ZIP
STREET ADDRESS
LOCATION
& PROJECT
INFO:
-u
~ 6 .?DIVISION NAME .
ADDRESS OF CONSTRUCTION
ZONING:
SQUARE , 1/
FOOTAGE: ~ J"i' .
SEWER UTIUTY 11
PROVIDER: L. 11
NAME OF UTIUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
A -/
A.
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
. Ai( SINGLE FAMILY )(1 NEW STRUCTURE
o TOWN HOME ~ ROOM ADDmON(S)
o TWO FAMILY 0 PORCH ADDmON(S)
# of Units: 0 REMODEL
o MULTI-FAMILY 0 ACCESSORY BlJl~N
# of Units: 0 .Q~~\1.I\6E ':-'
o RESIDENTIAL (For OCBO~~tiOI1S
Additions, RemodeIS~"'SS Cl..\\' . III es 0 Unifonn Plumbing Codew/lndiana Amendments
. ct to cow.; d LoCa "d . \J\CSS (MUlti-Family Construction Code)
PROJECT INFORMATI08lJblB \ State an 1'f SE.B Q
Early Release O~",~~YN\ -C{ 10WNS\-I\FOUND~T10N TYPE: (Check all that apply for the new
Permit: X-Y --12jij.Pl r.llSS1!S".J\SI..:i CY" \ _N construction area)
\r~ 0 Iv""" t"\D\"'~ '\ / 0 CRAWLSPACE 0 POST & BEAM
Lot Split: _ Y X-N' Sump Pump:- _ Y --?f-N ~ SLAB 0 BASEMENT
Does any part of the property lie within a special Flood designation area: _ Y C--1i WALKOlJT:_ Y_N
PLUMBING CONTRACTOR:
1:/'1 Ulrc;u
Plumber's Indiana State License #:
/0)'70 7'
Which plumbing codes will be applied to the construction:
~Intemational Residential Code w/Indiana Amendments
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 pennits 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 kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
used. or occupied u~til a tilicate of Occupancy has been issued by the Departmel!t of Community Se . ces, Cannel, Indiana.
Sign
Print
/2-(, -0'/
Date
NLY:************************************************************************
Filing Fees: S79.ID
,SPECTlONS REQUIRED: ""' / 11. 0 0 # Charged Re.
Base Inspections: ---p- ~ !L
Upper Footin Lower Footing r 0 , 0 i?'\ ReViews
Cert. of Occupancy: u v
P.R.LF.: 5:2 7. 6 0 Additional Fees
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