HomeMy WebLinkAbout04120054 Application
City of Carmel/Clay Township Permit #: o'f/7-0f}5Lj
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
PROPERTY NAME PHONE
OWNER: ,
STREET ADDRESS
LOCATION LOT#.
&. PROJECT
INFO: ADDRESS OF CONSTRumoi "3I41~
SEWER UTILITY Q.,1tW WATER UTILITY
PROVIDER: PROVIDER: :]:/1 .( /~
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
X SINGLE FAMILY l>;r NEW STRUCTURE
o TOWN HOME -TI'ROOM ADDmON(S)
o lWO FAMILY 0 PORCH ADD.1UON(S)
# of units: Ci$EROliiif'ON
o MULTHA!'ViREASED FOR th~~oati'QJUl:LDING
# of UnI~'J~ert In compliance OO~sHED GARAGE
o RESIDENTIAL For of State and L ~g~S'\GE
Additions, ~1~FtOOMMU I b(trr~~HIP
PROJECTIN~~~ARMEL/ CLAY
Early Release \./ I~~ured \./
Permit: .2S.....-Y _N Trusses: -A.-Y_N
V \( 0 CRAWLSPACE
Lot Split: _Y -""Io.-N Sump Pump: _Y -p-N )( SLAB ~
Does any part of the property lie within a special Flood designation area: _Y_N
BUILDER of NAME
RECORD:
NAME OF UTILITY EXCAVATION CONTRACTOR; PlAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WEll AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
an
FAX
Sf ATE
ZIP
ZONING:
SQUARE
FOOTAGE:
ESTIMATED COSf OF CONSfRumON: J 1")5
(EXClUDING LAND VALUE) 0(
v~,
PLUMBING CONTRACTOR:
51" I (rA.-li,
Plumber's Indiana State icense #:
I
/(/;-9" '7
Which plumbing codes will be applied to the construction:
~ntemational Residential Code w/Indiana Amendments
o Uniform Plumbing Code w(Indiana Amendments .
(MUlti-Family Construction Code) .
FOUNDATION TYPE: (Check all that apply for the' new
construction area)
o POST & BEAM
o BASEMENT
WALKOUT:_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 conform 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, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
used 0 occupied until 'ertif}cate of Occupancy has been issued by the Department of Community Services, Cannel, Indiana.
. . 1t:::D~ Clap
Prmt
NLY:***** ******************************************************************
Filing Fees: 5.. 2 ~ . I ()
ECTlONS REQUIRED:
Base Inspections: ?-ftJO ' 00 # Charged Re-
ReViews
Cert. of Occupancy: E"lJ. () 0
P.R.I.F.: 527 "- () '0 AdditiOnalFe~
~?r/'L!:!/f ~~~1::
Fee Recel by:
Upper Footin
Lower Footing
-
Site
(Date)
/2.. -6 -.0 >-
Date