HomeMy WebLinkAbout07050068 Application
City of Carmel/Clay Township Permit #0105 qO&f?
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
TYPE OF CONSTRUCTION:
~SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
BUILDER
OF
RECORD:
~
~W
d
PROPERTY
OWNER:
NAME:
FAX:
STREET ADDRESS:
STATE:
ZIP'
LOCATION
& PROJECT
INFO:
LOT. I SLo
SUBDIVISION NAME:
ADDRESS OF CONSTRUCTION:
SEWER UTILITY
PROVIDER:
Early Release
Permit:
PROJECT INFORMATION:
_Y iN
_y51N
o
o
o
o
Plumber's Indiana State License #:
1 'Q c::::;9 D J
,
Which plumbing codes will be applied to the construction:
~emational Residential Code w/lndiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
Lot Split:
Manufactured
Trusses:
Sump Pump:
'Xy N
XY=N
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB ~ BASEMENT (WALKOUT:_Y V; N )
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 permit, 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 r.c. 36~7 et seq, Geneml Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are co nected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupancy h een issued by the art e of Community Services, Cannel, Indiana.
Signature of
Date
5 -'1 -0]
,
Print
OFFICE USE ONLY: ********** *******************~~******~*************;r**~~**ttO'************ ***
INSPECTIONS REQUIRED: Filing Fees. ~' ::L.:2 !J
~ Base Inspections: -J)
~....ng CLower Foot@I>UnderSlab 0> :--(J
~ Cert. of Occupancy: ,L)':). .)
~ ~ Cffnal - Site ,) -) C; dO Additional Fees
~ ww. P.R.LF.: D' ~
~~ved: Dept.ofCommunityServices (Date) ~ ~~ 'o<#31/'0
# Charged Re-
Reviews
S:PermltsfFOI1l1sfILP RESIDENTIAL
Fee Received by:
Date