HomeMy WebLinkAbout07040119 Application
.,
City of Carmel/Clay Township Permit #:J)~(')4' () II q
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:
NAME: 1'0 '
\\, ,
STREET ADDRESS: \'Orn"_- ,C,o.\Ci3 Cu.v,,\?<.' 'or<:f (d. CITY:
NAME:
JD
ADDRESS OF CONSTRUCTION;
STATE:
ZIP:
STREET ADDRESS:
LOT#:
BEST METHOD OF CONTACT:
PHONE: FAX:
ELEASED FOR CONSTRUCTION
fut/;>jec\ to compliance vsi-~~!I regu atlo1WP:
f ~tate a,,, ,21 Codes ...,
I t- UUsE200ri{~1 i ~
,OF CARMEL / CUW
INDIANA
SEWER UTILITY
PROVIDER:
ESTIMATED COST OF CQNSTRucnON:
(EXCLUDING LAND VALUE) .t:::/
WATER UTIUTY (J ar Yl" pi
.OVIDER: ~''--''
NAME OF lfT1lfTY EXCAVATION CONTRACTOR;' LAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WEll AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
~ RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_V_N
_VLN
(;) J-
PLUMBING CONTRACTOR:
N('J (\.) e.,
Plumber's Indiana State li~~ #F. 6 2007
II /,
Which plumbing codes will be applied to the crinSti'ucti~;:'.
o International Residential Code w/Indi~.~~~~~ndments
o Unifonn Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & L BEAM _PIER
o SLAB 0 BASEMENT (WALKOUT:_V~N )
TYPE OF IMPROVEMENT:
o
.&
o
o
NEW STRUCTURE
ROOM ADDITION(S)
PORCH ADDITION(S)
DECK ADDITION(S)
REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
Sump Pump:
_V.::LN
..::Lv _N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is valid only if construction corrunences wit~n ISO
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy issued) within IS 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 Cannel Indiana - 1993" (2-
289) and amendments, adopted under authority of I.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 connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occup:mcyhas been issued by the Department of Community Services, Cannel, Indiana.
~a&d ~~dn.~t {2,'c:ho.rd fh
Signature of Owner or Au Orized Agent Print
"3 f- -+' w(} r-- f
~
Date
OFFICEUSEONLY:******************************~~******~***************~;(**i'~/******************
INSPECTIONS REQUIRED: Filing Fees, ,/.
/ /1,;Z So
__./ j/A
'-) ,,') i U
Upper Footing
Under Slab Base Inspections:
~. Cert. of Occupancy:
Site
. P,R.I.F.:
(Date)
Fee Receive y:
# Charged Re-
Revjews
Additional Fees