HomeMy WebLinkAbout07040005 Application
City of Carmel! Clay Township Permit #:fJ7 otf OOOb
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, 8< Two Family,: New Structures, Additions, Remodels, 8< Accessory Structures
"
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
8< PROJECT
INFO:
LOT#:
ADDRESS OF CON
1
SEWER UTILITY
PROVIDER:
~
PHONE:
NC.. .31'7~r;;J.1o
FAX'
(P6~ $/1 ,gJ3~/~
STATE:
iJ ;<5' G,
FAX:
ZIP:
~
SUBDIVISION NAME:
SEmON:
ZONING:
SQUARE /. 0'
FOOTAGE: Ct!fII6
ESTIMATED COST(Of.CONSTRumON:
(EXCLUDING LAND/VALUE)",,-
,. ; ) I ir-" I
;" jJI'~-'" ',.. . ""..... ".
II ~ ~ j --_'_'''~=~:~-,:L--~~~:..L~}i' /~ I I
" "I AP 'II II'
TAX MAP,~f<R<!I!"#: R - 2"0 ! III
,U Li' (107 II! Iii
I - I/! III
PLUMBING CONTRACT~.al3.~~b;;L
. . . tJ 'JJc I
-pC I (JifOO() lfZse; Ro~~:-W<dtoKes
WATER UTILITY
PROVIDER:
NAME OF UTILITY EXCAVATION CONTRACTOR; PLA.N COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATIO S)
FOR THIS PROPERTY:
Ie p um ing es WI e app e constru Ion:
li.. International Residential Code w/Indiana Amendments
6. Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TV \Q~eck all that apply for the new
construction ~\Of\"
~.~~\'j.
a. ~ . . . IlSI'1\CE POST & _~M _PIER
""On .:~l\6it11\^ 0"':"';1'
f>t~l~;,~f\~ fiII"';:': :t"" ALKOUT: Y_N)
For Single Family and Two Family dwellings, additions, remodels, an~~~Ws~ s, . . . ~.~~' y if construction commences wit:hlli 180
days of the date of issuance of the building pennit, and must be comp~fCer~HfE 9Wtip cf. ,,,;.)i~Vithin 18 months of the issuance date. Class I
.tructme permi" are .ubjeet to the General Admini"rative Rule. 01 the s~~a (SRt\N~(llr~arding expiration time fram" lor beginning and
comple . truceol1-~li'" e\\l" ..i
I, the undersigned, agree that any construction, reconstruction, enlargement,~a "c:fi),t ik'Jration ~~ructure;.or any change in the use of land or structures
requested by this application will comply with, and conform to, all applicable 0 t:A't State of Indiana, and the ~Zoning Ordinance of C~rmel Indiana - 1993~ (Z'
289) and amendments, adopted under authority of r.c. 36'7 et seq, General Ass Iy 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 occupied until a Certificate of
Decup cy," been i,",ued h e epartment 01 onununi Semc", Carmel, Indiana. <'() / I I
. SHERR..VC 1< (rc.!+1 e '1/2, / 01
Print Date
TYPE OF CONSTRUCTION:
,J~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
i. time:
RESIDENTIAL (For
Additions. Remodels. Etc.)
::r1~J::a:FORMATIy IN /
Permit:
Lot Split: _y'
TYPE OF IMPROVEMENT;
o NEW STRUCTURE
.~ ROOM ADDITION{S)
o PORCH ADDITION(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish orily
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
~i
Sump Pump:
OFFICE USE ONLY: ******************************~~*******************S*** V~***iZ****************
INSPEcnONS REQUIRED: FIling Fees: . ~ 6',' ,
B I ct d II 0 # Charged Re-
. t' U ase nspe Ions: Hi (J
~ooln /0 ~
Cert. of Occupancy: ,~'S. ,) I
P.R.I.F,:
/ 2) ~' Additional Fees
~ 8c---Q/'
TOTAL: 0 t. %
~/ ' 4-1,~ /0'1
Date
c.\"'6- ' . J -10-
Reviewed/App oved: Dept. of Community SelVices (Date)
S:PermltsjFormsjILP RESlDEf'lTIAL
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