HomeMy WebLinkAbout07040105 Application
City of Carmel/Clay Township Permit #: 01QL/ DICfj
I
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:
00 F:CONt~cr:tF' IS n \\n ~ i.:
"\\ilS\'..'7lSU \'If IS'I
., \ ._ 11
\\~~\\ FAX: III Ii
\ U Urm: ZIP: \ e; i
I L I
, I
SEmON: ZONING: J
L
BUILDER'S EMAIL ADDRESS: fY) e. (l
NAME:
STREET ADDRESS:
LOT #:, ()
At
ADDRESS OF CONSTRUCTION:
SQUARE
FOOTAGE
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
SEWER UTIlITY fl ~ WATER UTIUTY 11 f\J if
PROVIDER: G PROVIDER: Cj).J f
NAME OF UTIlITY EXCAVATION CONTRACfOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
TYPE OF IMPROVEMENT:
~EW STRUCTURE
o ROOM ADDITION(S) Plumber's Ind'aA~Wii
o PORCH ADDITION(S)
o DECK ADDITION(S)
o REMODEL Which plumbing codes will be applied to the construction:
_ Basement Finish only
o ACCESSORY BUILDING ~ntemational Residential Code w/lndiana Amendments
o DETACHED GARAGE .. .
o ATTACHED GARAGE 1tJ~ _ 0 Uniform PlumbIng Code w/Ind,ana Amendments
o DEMOLITION 8. 'E:l.t~, ~UNDATION TYPE: (Check all that apply for the new
Manufactured ~ . IJ6;GCf,ic(j'.,'f,.?;;.'lton, area)
Trusses: '7s!i!!.f ..O~Slti:r:fj4g~ywrCE
Sump Pump: C~=7".0f:" ~!~/jfi"/.J(J(j~ .
o ". C_1!ft1
For Single Family and Two Family dwellings, additions, remodels, and/or accesso;; ,li'L~, ~i~~Ji.s;.O ctioD commences within 180
days of the date of issuance of the building permit, and must be completed (Certificate,o~vP~fffJGe hin ufMlfdths of the issuance date. Class I
structure permits are subject to the General Administrative Rules of the St.ate of Indi~QS"M.01V e tJt~Eration time frames for beginning and
completmgconstrucnon. ~^t~ OlA.I''' _~I:::'
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration-o'Fafstructure, d~ n e 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 ce of Carmel Indiana - 1993" (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 flQ.or dra s are connected to the samtary sewer I further certifx that the constructIon will not be used or occupied until a Certificate of
Occup c hasbeen"su Y.t D PartmentofCommurutysemces'~lndi~i. qfiJJ _~-(p ~7
S'gnotu", of ,ed Agen .,Int ~ Oote
TYPE OF CONSTRUCTION:
~NGLE FAMILY
"0> TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
Early Release
Permit:
PROJECT INFORMATION:
_V sf
V N
Lot Split:
ESTIMATED COST OF CQNSTRUcnON:
(EXCLUDING LAND VALUE)
07D4o CJ/
TAX MAP PARCEL #:
o POST & BEAM _P~
MENT (WALKOUT; V v'N)
OFFICE USE ONLY: ************* ************** *************************~***************************
INSPECTIONS REQUIRED: Filing Fees: 6-~;2... ~O :
..c.:: . Base Inspections' "") p 7..;:> (;J # Charged Re'
~er'Footi~ LliiNe~ Footi-;;g Under Slab . C7 ~ s. .st/ Reviews
Cert. of Occupancy:
~ ~se P.R.I.F.: Il.- GilO
~ ~~
Additional Fees
Reviewed/Approved: Dept. of Community Services (Date)
S:PermitsjFormsjILP RESIDENTIAL