HomeMy WebLinkAbout07030129 Application
City of Carmel/Clay Township Permit #:071'J.3<p l..dt9
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:
NAME:
NAME:
STREET ADDRESS:
LOT #:
ADDRESS OF CONSTRucnON: , :J.i.! ~
SEWER UTILITY 11 -n1/, ,.,.....,
PROVIDER: V (.t<-tIU V
WATER UTIlITY
PROVIDER:
FAX:
STATE:
ZIP:
ZONING:
SQUARE
FOOTAGE: 2>olY1
ESTIMATED COST OF CONSTRumON: ~----.
(EXCLUDING LAND VALUE) .~ CJLlL)
NAME OF UTILITY EXCAVATION COI'ITRACTOR; PLAN COMMISSION / BZA / BPW DOCKET A I
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE): .
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PR.OPERTY:
TYPE OF C NSTRUcnON:
SINGLE FAMILY
TOWN HOME
TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.1
Plumber's Indiana tat~m#:
/ (JY-f(~
.
Which plumbing codes will be appli~d to the construction:
~ntemational Residential Code w/India.na.'~mendR1ents
o Uniform Plumbing Code wi Indiana Am'~I;d.i,ents '
:.\i)W'''~
FOUNDA!10N TYPE: (CheCk~i!:}b~~~~ the new
construction area) iQ"(..'f..'I.)'~I;:;\'Q.""O
o CRAWL5PAC~ oej''i'i'i' ~~.\~a.......PIER
o S t~e,~~~'l... ~N,)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structure~~'~. ~~iffi:~~c_~~ c ences within 180
day' of the dat< of i"m~ce of the building permit~ and mu" be completed (Certifkate of Oc '\1;;~ . ~~He i"uance da~e. Cl"" I
structure penmts are subject to the General AdnUnistrative Rules of the State of Indiana (See 6 C 12) r~ tW\4frames for begmnmg and
completing construction. t""'~O"\ \J' bo..~ ~~\n\~\"'"
I, the undersigned, agree chat any construction, reconstruction, enlargement, relocation, or alteration oft>","ktfNi~C',,!:Iy chadge~ the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the State of Indian,,~h~~of!ing,Ordinance of Cannel Indiana ~ 1993" (Z'
289) and amendments, adopted under authority of LC. 36'7 et seq, General Assembly of the State of IndilQl~l~d all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. 1 further certify that the construction will not be used or occupied until a Certificate of
Occup cyh", been i, d Department of Community Service,. Carmel, Indiana. I~
ll' '01
o.~
Early Release
Permit:
PROJECT INFORMATION:
_y~
_yLN
Lot Split:
TYPE OF IMPROVEMENT:
KNEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o DECK ADOITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
Vy N
VY=N
07C>'bOldt8
Sump Pump:
TAX MAP PARCEL #:
~~
PLUMBING CONT
&w
NLY:*****************************************************~ft************************
NSPECTIO REQUIRED: Filing Fees: Clff'1 17'1> .
Base Inspections: ,-;:;> -? 7 \'J' {l # Charged Re-
Reviews
:).). ~O
/ ,;} c/ j tJ Additional Fees
TOTAL: ( . lY;if/cF) :10
~~ 3/~
P,R.I.F.:
Cert. of Occupancy:
C:""~:(l MI~ 3-?-3-07
Reviewed/Approved: Dept. of Community Services (Dale)
S:Permits/formS/ILP RESIDENTIAL
~,.
Fee Received by: