HomeMy WebLinkAbout07040136 Application
(~~~S~:~~~tEMENT LOCATIONPE~;~p~~1fr~~
\ :~Q:~~:// For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
SEWER UTIUTY WATER UTlUlY _ ESTlMATED COST OF CONSTRU
PROVIDER: C PROVIDER: [ArM t, L- (EXCLUDING LANO VALUE)
NAME OF UTlLllY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I.!IP' ~~):..FO. .(?Iro.
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT'i9' TI.TGorn .:.t;
FLOOD ZONE AREA DESIGNATI N(S) OEPT OaF etate and L( c T
FOR THIS PROPERTY: " il OIWI I
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: CARiPi. M
~INGLE FAMILY ~NEW STRUCTURE IN ~
o TOWN HOME 0 ROOM ADDITION{S) Plumber's Indiana State License #:
o TWO FAMILY 0 PORCH ADDITION{S) n p COO \ 0'1
# of units being 0 DECK ADDITION(S) L _ I _ _
constructed at this 0 REMODEL
time'. . . I ;(:.ic plumbing codes will be applied to the construction:
_ Basement FinIsh on y
o RESIDENTIAL (For 0 ACCESSORY BUILDINr-~ International Residential Code w/Indiana Amendments
Additions. Remodels. Etc.) 0 DETACHED GARAGE .' .
o ATTACHED GARAGE ~ UnIform Plumbing Code w/Indlana Amendments
o DEMOLITION
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
NAMPUL 115
PHONE:
57S-:X?&j )( JDfo
q2-
HOn
CITY:
BEST METHOD OF CONTACT:
t:.mAI L
PHONE:
FAX:
CITY:
STATE;
ZIP:
ZONIN~ '..1-
SQUARE
FOOTAGE: 50 I 0
_y V'N
-y~
Manufactured
Trusses:
Sump Pump:
t/'y N
JZy _N
FOUNDATION TYPE: (Check all that apply for the new
construction area)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB ~SEMENT_(WALKOUT:_Y ~)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is valid \'~Y:-~_&I!~t~c~J()N~_~~~!!.c~e~ fitiun 180
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy issued) withfu IS months of the issuance da~~.~ q3;~s I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 IAC 12) regirdidg1expiration time frames for beginping and
completing construction. Ili\ \ i A PO 1 Q ~nn7 . i I i II
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure,?~ a~y change~nl~he se16f lafiO-Jor stru.ctu~~s.' I
requcsrcd by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the ":';;:oning Ordinance of Carmel Indiana - 1?93~ (Zt
289) and amendments, adopted under authority of I,C. 36-7 et seq, General Assembly of the State of Indiana, and all AEts amendatory_thereto..I [urthercertilfdiar only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will notbe used or occupied until a Certificate of i
Occup:mcyhas been issue b the Department of Community Services, Cannel, Indiana. L. _ _ ~ ~~ __J
'JOI\NN F. SH fPrlE:l2rl j1[u1Ql
Print Date
EUSEONLY:*****************************************************9**~**********************
.. F . c6JJ de
INS. PECTION REQUIRED: Filing ees. r-l :r''7.-::;O
~ FO~ Under Slab Base Inspections: -.- /" 1)
~ Cert. of Occupancy: <) . )
gh Final Site
\J ~ ~ P.R.J.F.:
# Charged Re-
Reviews
(Date)'
Addibonal Fees
Reviewed/Approved: Dept. of Community Services
S:Permits!FormsjllP RESIDENTIAL
Fee