HomeMy WebLinkAbout07060102 Application
City of Carmel/Clay Township Permit #:~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Singl Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
FAX:
~ (p 5'- 71:'- 35"1:2.
STREET ADDRESS:
BUILDER'S EMAIl ADDRESS:
rlJ'e1D
NAME:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
SEWER UTILITY
PROVIDER:
S.Cw
Ii< 5A- L._
CITY:
ZIP:
ST~?2N
B METHQlLQfr=~\3.\lce with all regulations
ub eeno "UTn)' . ,..J J '
l:;n' A!l'l\.4lQQl Codes.
DEPT OF COMMUtlUIY SHIP
-.s;; " L CLA'{ TOWN
SJNE}\ANA AZIP:
-, 7- /e<'33
STATE:
/' 'ToAf
PHONE:
d
SECTION:
2...
ZONING:
-I
/.r.,p 33
SQUARE
fOOTAGE:
3',:20s F'1.
ESTIMATED COSTOFCONSTRUcnON: ~
(EXCLUDING L'AND'VALUE) "co. --.n_.~, ""''''' _.
r: I \ 1 II .!... I ",6 C)
"L) 'r
.. II' ./' '/
/v, ~ nil ;i ! I,
TAX MAp PARCEL #: 1 2 2007 III I II'
i:J U! ill / )
PLUMBING CO'NTRACT~- 1'---' I
'--
Xf/:4-~-n~
Plumber's Indiana state License #:
NAME OF UTILITY EXCAVATION CONTRACfOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATIONC;)
FOR THIS PROPERTY: ,\
TYPE OF CONSTRUCTION:
illl 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: -.ll y. N
I~--
Lot Split: _VVN
TYPE OF IMPROVEMENT:
NEW STRUCTURE
ROOM ADDITION(S)
PORCH ADDITION(S)
DECK ADDmON(S)
REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOlmON
o
o
o
o
j([
Manufactured
Trusses:
Sump Pump:
_VLN
_V ~
Which plumbing codes will be applied to the construction:
o International Residential Code w IIndiana Amendments
o
Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
~onstruction area)
.~ 0 CRAWLSPACE 0 POST & _ BEAM _PIER
~ 0 SLAB ~ASEMENT(WALKOUT:_V_N)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences within ISO
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 confonn to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Cannel Indiana -1993~ (z-
_289) and amendments, adopted under authority of LC. 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
Occupancy has been issued by the Department of Community Services, Cannel, Indiana.
'-dJ1, . f .. ~ '71n ~ M 1c.J.lAG't-
19n~t~f-;;= or Authorized A9~t Print
/III <'-jII1AIII..!
&-,-11) -0'7
Date
OFFICEUSEONLY:*********************************************************************************
INSPECTIONS REQUIRED: Filing f~ees: .- / ~ '? <:,(f
Base Inspections: / I~' d 0- .
Lower Footing Under Slab I
Cert. of Occupancy: ::::'J. SO
Me~~r Base ~ ~
_ __ _ _ P.R.I.F.:
~~
. of Community Services
S:Permi FormS/ILP RESIDENTIAL
b'I%-O
(Date)
# Charged Re-
ReViews
Additional Fees
#'30100
Fee Received by:
Date