HomeMy WebLinkAbout07030224 Application
City of Carmel/Clay Township permit#:()?630J~~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, llr. Two Family: New Structures, Additions, Remodels, llr. Accessory StrJctures
,
TYPE OF CON' , F.R
_/': \'<
Ild'~ SINGLE FA
o TOWN HO.,
o TWO FAMU
# of uni
construct
time:
VRESIDENTIAL
Additions. Remodels. Etc.)
BUILDER
OF
RECORD:
f) 3- 97
IS
FAX:
&~3':
ZIP:
'-1<0
PROPERTY
OWNER:
ZIP4i.cO
LOCATIO
llr. PROlE
INFO:
SECTION:
ZONING:
SQUARE ,
FOOTAGE:
SEWER LfTILITY
PROVIDER:
ESTlMATED COST OF CONSTRUcnON:
(EXCLUDING LAND VALUE) .jt.
TAX MAP PARCE #:
PLUMBING CONTRACTOR:
h'Yi.~U(y\b;~
Plumber's'l iana State License #:
_3=1' ?5~/610 g;r
PROJECT INFORMATION:
o
o
o
o
Which plumbing codes will be applied to the construction:
o International Residential Code wjlndiana Amend~ents
,
o Unifonn Plumbing Code wI Indiana Amendments
Early Release
Permit:
Lot Split:
j .....J...Manufactured
Y N1'Y'" Trusses:
Y ..; N Sump Pump:
VY_N
~Y_N
,
FOUNDATION TYPE: (Check all that apply for the new
construction area) I
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB arBASEMENT (WALKOlfT:_ Y ...+N)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is valid only if constru i &\nnences within ISO
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy issued) within IS ~~ce date. Class 1
structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regardU'o , es for beginning and
completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration 0 rein the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the State of ng Ordinance of Carmel Indiana - 1993" (Z'
289) and amendments, adopted under authority of I.c. 36-7 et seq, General Assembly of the State ~1'Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the const tion will not be used or occupied until a Certificateo!
DCCll cyh.s be "ss h the Depart nt 01 ommumty Semces. Cr~l.Indiana J
. , Wrr; (l[y}J les,ior\ 31~(J. 07
Print Date
,
OFFICE USE ONLY: ************************************** *******************y**********************
F"I" F /' 0 u () J-
INSPECTlONS REQUIRED: ling ees: S '
~. F t" U d SI b Base Inspections: ;la-I). ()O
pperoll1 oweroom "era ____
G ~ Cert. of Occupancy: S .J . u 0
ough In Meter Base Final Site
_ P.R.I.F.: Additional Fees
TOTAL: P frO.5:L.. I
~/?~d !
# Charged Re-
Reviews
S:Permits/forms{IlP RESIDENTIAL
Fee Received by:
Date
/1
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