HomeMy WebLinkAbout07030201 Application
City of Carmell Clay Township Permit #: 070.300\01
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:
bp,
STREET ADDRESS:
ZIP:
</, J &'
PROJECT INFORMATION:
CITY:
STATE:
,.5 IN
BEST METHOD OF CONTACT:
- ;)00
I
BUILDER'S EMAIL ADDRESS:
NAME:
FAX:
CITY:
C
STATE:
IN
ZIP:
SECTION:
ZONING:
$-
SQUARE
FOOTAGE: S q
ADDRESS OF CONSTRucrrON:
S
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / ~
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S ~~P
V
FLOOD ZONE AREA DESIGNATION(S) 0/0 C\
FOR THIS PROPERTY; X -- ~
TYP OF CONSTRUCTION:
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
Early Release
Permit:
Lot Split:
~~
ESTIMATED COST OF CON5]fUcnON:
(EXCLUDING LAND VALUE) It a I 0
o
o
o
o
FOUNDATION TYPE:
construction area)
o CRAWLSPAC
o SLAB
o P BEAM _~R
MENT (WALKO' Y LN )
,-
Manufactured
Trusses:
Sump Pump:
--4 _N
~Y_N
For Single Family and Two Family dwellings. additions, remodels, and/or accessory structuresrtIiifP"ennit is valid construction o~ences within 180
days of the date of issuance of the building pennit, and must be completed (Certificate of Occ~pancy i . within 18 mO!lJatt,pf th~ ~su#~e date. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 I~ ) regarding ~Ita~ ~e frluh~s for beginning and
completing construction. \ r (\ \ \ ,f\C\1."6 \ ~ (
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration ofalftfucture, 1i\JM\"y change in the use.ofland or structures
requested by this application will comply with, and conform to, all applicable laws of the State of Indian~\ and ~he ~Zoning Grdin e.o{,Canneflb.'diana - 1991''' (Z-
289) and amendments, adopted under authority of r.c. 36-7 et seq, General Assembly of the State of India\1iiar4I\~ll Acts atQ1Y\tIf€ret1.~Hurther certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the constructiri~\\rin\tq!_~. . u1",o\\o~d~ti1;' Certificate of
Occupancy has heel\. issued by the Department of Conununity Services, Carmel, Indiana. \. \ \ \. \ {~\ 11 ';-:---
. a. 'Lop,; IL g;Rb50tJ6- J.i~~1,~-;;- 3jJ~/o7
Print Date
OFFICE USE ONLY: *******************************************************
Filing Fees:
Base Inspections:
o
Cert, of Occupancy: , ~3. )~O
P.R.I.F.: I;; h rOo Additional Fees
~ ' 'L .~
. ~..,~ ~ ..0',:;20'70-90
c~ f-&- -
# Charged Re-
Reviews
116 g
Date
Fee Received by: