HomeMy WebLinkAbout07060082 Application
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City of Carmel/Clay Township Permit # :J)j tJ ~ 00 S;-
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
i
I
\
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER lITIlITY
PROVIDER:
NAt. J:
EtEi&)RElJ
BUILDER'S EMAll ADDRESS:
~u Elfi2
FAX;
BEST8~(lI~<lIO'MjlijiancG with all regulations
of State and Local Codes.
PHONE;' OE'PT OF COMM~ITY SERVICES
S ~ CARMEL CLAY TOWN HIP
CITY; STAlNDIANA ~IP;
CMLM 8- ...pJ 4 "033
SECTION:
'20
STREET ADDRESS:
IS" 2....3 QufBJS8oeoI.lE,l-4 {)g..
lOT :
\
eo UE;.t-1
Gtrmd
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) 2-
(X)o
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNlY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE);
FLOOD ZONE AREA DESIGNATlON(S)
FOR THIS PROPERTY:
PE OF IMPROVEMENT:
o NEW STRUCTURE
ffi-RIlIlI1 Arl5ffI9N(li) iI ~ 11
~ PORCH ADDmON(S)_
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o AlTACHED GARAGE
o DEMOLITION /
Manufactured
Trusses: _Y ~N
Sump Pump: _Y ~
TYPE OF CONSTRUCTION:
if SINGLE FAMILY
o TOWN HOME .\
o TWOFAMILY ~;~p&
# of units being t";. .~
constructed at th.
time: td ~
o RESIDENTIAL (For
Additions. Remodels. Etc.)
Early Release
Permit:
PROJECT INFORMATION:
~~
Lot Split:
TMMAj>;PAR. CEC.-#: - ..:.-. ' ,,-.:, .: - -.. -. ---I
~~ I:. (-' :'~1006axJ
PLUMBING CONT~ch-OR: I'll li)1
/H loi-r',i I I .
IV Wl:fl1 1\ I .IUN 8 ?007 ,! 1
Plumber's Indian,,:I;tl>te License #: Ii U 1'1
IiI l.'L L::J ;1
Which plumbing calles will be ap"p'lied to the construction: ,:1
o International Residential Code w IIndiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area) ./"'
o CRAWLSPACE G"'POST & _ BEAM _PIER
o SLAB 0 BASEMENT (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. ~Iass 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 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 KZoning 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 amendato~eretO:-rfurther 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 0 upied, u.ntil a Cd neat of
Occupancy has been is ued by epartment of Community Services, Cannel, Indiana. C. 6 ( . 3 0
Sig
Print
Date
*****************
OFFICE USE ONLY: ************************************************************:+;**
Filing Fees:
Base Inspections:
Cert. of Occupancy:
I
CTIONS REQUIRED:
Lower Footing Under Slab
Meter Base ~ ~
. ("0
/1/ 0# Charged Re-
Reviews
S-5'- S-(/
5-1.J..o7
(Date)
P.R.I.F.: /
(~~v d
I Fees
S:Permlt5fFormsfILP RESIDENTIAL
Fee Received by:
Date