HomeMy WebLinkAbout07040012 Application
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City of Carmel/Clay Township Permit #fi1I2!l.QQld-.
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:
SEWER lJTILfTY
PROVIDER:
NAME:
NAME:
STREET ADDRESS:
ADDRESS OF CONSTRucnON:
ERELEASED FOR CONSfRUCTION
u Jec 0 STATF' " ZIP
of State anti Lr)c'al COdES. :
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,. .'....sE.q!q,L;'''. r'.! X' ZONI.N,~'NSHIP
CITY U'j" ,,',c,I,', ..' ~., . ~
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ESTIMATED cosT OFtoNSTRUCT10N: I:! 'II j:
(EXCLUDING LAND VALUE) II /' i
III II! , j I
A I:; U ~u.' III J I'
II, :;IJ; 01 QlJ/6 h II
I
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NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
'P(" SINGLE FAMILY
a TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels, Etc.)
Early Release
Permit:
PROJECT INFORMATION:
_yV;;-
_ydN
Lot Split:
TYPE OF IMPROVEMENT:
1s:J,. NEW STRUCTURE
-0. ROOM AODITION(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
Manufactured
Trusses:
Sump Pump:
0N
~N
,
TAX MAP ~RCEl #:
Plumber's Indiana State Licenq ,
\D~O
Which plumbing codes will be applied to the construction:
~ntemational Residential Code wjlndiana Amendments
o Uniform Plumbing Code wjlndiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM _PIER
o SLAB BASEMENT (WALKOlJT:_Y )
For Single Family and Two Family dwellings, 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 pennits 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 Carmel Indiana - 1993" (Z-
289) and amendments, adopted under authority of l.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 drams are onnected to the samtary sewer I further certify that the constructiOn Wlll not be used or occupIed untIl a Certjncate of
Occupancy :been ",ued by t e t nt of Commuruty Semceo. Carmel, Indiana 7/ ::LJ!{) 7
Signature 0 ner r u Date
OFFICE USE ONLY: **********************************************************
Filing Fees:
Base Inspections:
Cert, of Occupancy:
# Charged Re-
Reviews
S:Permits!FormsjILP RESIDENTIAL
P.RJ,F.:
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Additional Fees
Fee Received by:
Date