HomeMy WebLinkAbout07040008 Application
\ ICity of Carmell Clay Township Permit #: Cn 0+0005<
.1 ~~RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, Br. Two Family: New Structures, Additions, Remodels, Br. Accessory Structures
ADDRESS OF CONSTRUCTION:
i
BUILDER
OF
RECORD:
NAME:
PROPERTY
OWNER:
NAME:
STREET ADDRESS:
LOCATION
Br. PROJECT
INFO:
LOT #:
SEWER UTILITY
PROVIDER:
~-n
PHONE:2S5~Cf1d)
PHONE:
RELEASED FOR ~STRUCTION
'H~~' ,<,I;~ f" ,dh r .) latIons
of Staar~1F~j L Qcal cnaW':).
,..\C rni\,b(' ,~' ji'J\TV sr':RVICES
CITY c5'F"3MiViEL 1..:~tlNGTGWNSHIP
CITY:
SQUARE .
FOOTAGE:~
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
';--..
TYPE OF IMPROVEMENT:
~ NEW STRUCTURE
-0 ROOM ADDmON(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o AlTACHED GARAGE
o DEMOLmON
)Q
'() A! r '; i L~~-; ;":(; r:~'*'~'7"':ruT-'-
r\ .\[ I. ) I - '::~JG./~,::.~~.~ JZ11 .
r I~, ~ I "1 II'
TAX MAP P~cr~ r,: ! J I r Ii
lif ill APR - nil/Iii
PLUMB~~t5~:w-JL01
Plumber's Indian.State Lrcense,#,--------- J
LO\ 1L) -
. Which plumbing codes will be applied to the construction:
~ International Residential Code w/Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC OATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERlY:
TYPE OF CONSTRUCTION:
~SINGLE FAMILY
- C5 TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_yVN
_yLN
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Manufactured
Trusses:
Sump Pump:
VY_N
VY_N
o CRAWLSPACE
o
o POST & BEAM PIER
SEMENT (WALKOUT:_Y~)
SLAB
For Single Family and Two Family dwelhngs, 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 pennit, 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 Cannel Indiana - 1993n (Z~
289) and amendments, adopted under authority of r.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 nected to the sanitary sewer I further certify that the constructIOn will not be used or occupIed until a Certificate of
Occupancy beenis...edbyt ep ntofCommurntysetvlces'9Ind,ana, '"- kqfD7
.,,", 0... ~ ,
Under Slab
# Charged Re-
Reviews
Fee Received by:
Date