HomeMy WebLinkAbout07050239 Application
BUILDER of
RECORD:
\J(Jj/lh-lr /81D I1toJlu AufU/OI/ 6 "7 5'023
City ofCarme//Clay Township Permit #: () 0 1
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICA1'ION
For Single Family, Multi-Family, & ~i\llb~ Structures, Additions, Remodels, & Accessory Struf:tures
. ,
hOnnon i nShOUfHONE FAX
STREET ADDRESS
STATE
ZIP
NAME
PROPERTY
OWNER:
NAME
PHONE
FAX
STREET ADDRESS
CITY
STATE
ZIP
LOCATION
& PROJECT
INFO:
SQUARE I) /1 0
FOOTAGE:c;1 of 0 0
SEWER UTILITY
PROVIDER:
NAME OF lJTIUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
-95- TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
~ NEW STRUcrURE ~r Lfr'vw.1u..--
o ROOM ADDITION(S) Plum er's Indi~.!:State License #:
8 ~O~RCH A~DITION(S) I o,~ Of) 05 7
o AC ~~rP:U~JG Which plumbing codes will be applied to the construction:
o D j(_~~E"OR CSfvlnternational Residential Code w/lndiana Amendments
8 ~I!~C~CQ ~'ance \w;~~Jifl,l.KPr"l!!JtiJ'g Code w/lndiana Amendments
C~I 1::1 /....0 IJd Local d!;1~./lIl~Yibg':trucllon Code)
PROJECT INFORMATION: try 01= v MMUN Odes ns
Early Release V Manufactured XCAAMtL / c/~cE; TYPE: (Check all that apply for the new
Permit: - Y ~N Trusses: - Y --1A,J!j/AN ~'Y '-tt'~N.s S 0 POST & BEAM
Lot Split: _Y iN Sump Pump: ~Y AN ~ ~ SLAB 1Wj5. 0 BASEMENT
Does any part of the property lie within a special Flood designation area: _ Y ..AN WALKOUT:_ Y_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 permits 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 strucrure, 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 lndiana, and the "Zoning Ordinance of Carmel
lndiana - 1993" (Z~ 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 arc connected to the sanitary st:wer. I further certify that the construction will not be
use or occupied umil a ertificate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
l" r- lrJ-/!};JJ{)JJ I-lTNJ/--IiJlA./ 5-f)~ -07
Print
Oate
~ Reviewed/Approved: Dept. of c~mmunity Services
~ \ S,Pe<miWocm"lLP RESIDEtmAl
OFFICE USE ONLY: ************************************************************************
Filing Fees: ?#3J... on
SPECTIONS REQUIRED: ";A q 7 ~OJ
Base Inspections: U . "-J"U
Cert. of Occupancy: ~~ p SO
P.R.I.F.: -S ~ '1. 00
!J!;;t: ~~~o~.t~~
Fee Received by: ~ ~ ~
# Charged Re-
Reviews
Additional Fees
(Date)