HomeMy WebLinkAbout04120058 Application
City of Carmel/Clay Township Permit #: () 4/11 () DSQ
I
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory strJctures
BUILDER of
RECORD:
NAME
NAME
PROPERTY
OWNER:
STREET ADDRESS
ZIP
LOCATION
& PROJECT
INFO:
ZONING:
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DDCKET
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
ADDRESS OF CONSTRUCTION
1339
SQUARE
FODTAGE:
i
L
SEWER UTILITY
PROVIDER:
WATER UTILTTY ':-. I
PROVIDER: -1--... J. )
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
..k' SINGLE FAMILY ~ NEW STRUcrURE L / C-ru #-
o TOWN HOME d ROOM ADDmON(S) Plum~r';;;;diana state I/Icense #:
o TWO FAMILY 0 PORCH ADDmON(S) )
# of units: 0 REMODEL ()j - '7 () I
o MULTI-FAMILY 0 ACCESSORY BUILDING Which plumbing codes will be applied to the construction:
# of Units: 0 DETA);I:;U;p,~i\RAGE ~ Intemational Residential Code w/Indiana Amendments
o RESIDENTIAL (For C~liIi\U~E!lYG't>.RAGE
Addition~~"t2P1l!lEacf50R ~v a!lIi~IilS Unifonn Plumbing Code w/Indiana Amendments
~~.omp\iance mtf\ (Muiti-Family Construction Code) 'I
PROJECT IN ..~ t and Local Codes. S
o ::ita e >cv.cC:i:'lV\CE FOUNDATION TYPE: (Check all that apply for the new
Early Release m ~M~ltUraalR'e(ll.J:.\"\-l\P t ct-
Permit: 05.p 'AE\Tru~'Y TO~'Y' N cons ru Ion area)
C\ 1= \' L. I \7 0 CRAWLSPACE 0 POST & BEAM
Lot Split: _Y N \N~A'JtAump: _Y ....QLN ~ SLAB 0 BASEMENT
Does any part of the property lie within a special Flood designation area: _ Y ~ 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 Carmel
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 or occupied/ntll ertmcate of Occupancy has been issued by the Department of. CommuUlt~ S~es, Cannel, Iudiana.
Imh (_r~ /7 -, -,,(/
Print 0'-' -1 DlteV' ,
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Filing Fees: .s 7'i! . /0
~fJf},()O
OtJ I O()
S 2Q, DO
,
. /- IS.
Base Inspections:
Cert. of Occupancy:
# Charged Re-
Reviews
Additi7
--rJt.I
Fee Received by: