HomeMy WebLinkAbout04120059 Application
City of Carmel/Clay Township Permit #: 04 /2DOSC1
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, S. Two Family: New Structures, Additions, Remodels, S. Accessory Structures
BUILDER of
RECORD:
NAME
PHONE
FAX
PROPERTY
OWNER:
STREET ADDRESS
STATE
ZIP
LOCATION
s. PROJECT
INFO:
LOT # . SUBDIVISION NAME
~7.3
ADDRESS OF CONSTRUCTION
,~ "3'5~
ZONING:
SEWER lITILITY
PROVIDER:
WATER lITILITY
PROVIDER:
SQUARE
FOOTAGE: 'Dl5
EST1MATED COST OF CONSTRUCTION:
(EXQUDING LAND VALUE)" 5 ocf)
NAME OF lITILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEmc PERMIT #'S (IF APPliCABLE):
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
. ~ SINGLE FAMILY X NEW STRUCTURE rc; "" / c.',-~-'1'
o TOWN HOME 0 ROOM ADDmON(S) Plu~ber's Indiana State License #:
o TWO FAMILY 0 PORCH ADDmON(S)
# of units: 0 REMODEL /O)-'f"'t
o MULTI-FAMILY 0 ACCESSORY BUILDING Which plumbing codes will be applied to the construction:
# of Units: 0 DETACHED GARAGE ~ International Residential Code wI Indiana Amendments
o RESIDENTIAL (For 0 ATTACHED G4\AA.<PE
Additions, Remodels, Etc.) r;;)O\Q~NIU" 0 Unifonn Plumbing Code w/Indiana Amendments
PROJECT INFORAji:~j;ED fO~~ wilh all reguialions (Mulb-Family Construction Code)
Earl R I subjecl 10 com~,r;;ades. FOUNDATION TYPE: (Check all that apply for the new
per~it:e ease A-y of,plal..:l: !'Ii'lITY S~tcEShl. construction area)
Dl"P~'~ cu~~ ;y TOWNsttl't" 0 CRAWLSPACE 0
Lot Split: '"'Y"Ot:-~AR~~ _YAN Js(-SLAB ~ 0
Does any part oHIkYproperty lie ;td1~ial Flood designation area: _Y_N
POST & BEAM
BASEM ENT
WALKOUT:_Y~N
o ,
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 atlthority 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 cupi~ until 'ertificate of Occupancy has been issued by the De artment of Community Services, Carmel, Indiana.
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Print
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Filing Fees: fa 2? . 'Lt"")
CTlONS REQUIRED: n,; _ Q _ fi'lO # Charged Re-
Base Inspections: -9l,.(g _ . (.,of
U "'~ . J'I'\ 0 ReViews
Cert, of Occupancy: --..J...LL _ v
P.R,LF,: 6;27. [) f) Additional Fees
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