HomeMy WebLinkAbout07060127 Application
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CIty ofCarmellClay Townshtp Permit #:
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
NAME:
H
PROPERTY
OWNER:
STREET ADDRESS:
LOCATION
&. PROJECT
INFO:
LOT #:
~2
/ I-fr-.-, ~~;(
ADDRESS OF CONSTRUCTION:
If J"t
SEWER UTILITY
PROVIDER: CT;z GJ <f)
WATER UTlLI1Y
PROVIDER:
o
RUCTURE
RO ADDITION(S)
" RCH ADDITION(S)
ECK ADDITION(S)
REMODEL
_ Basement Finish only
ACCESSORY BUILDING
DETACHED GARAGE
ATTACHED GARAGE
DEMOLITION
Early Release
Permit:
Lot Split:
Manufactured
Trusses:
Sump Pump:
v.{N
~ N
_Y_N
_Y_N
PHONE:
FAX:
J'YC- 2'it7-
() STA:,t.u-:
CITY:
ZIP:
VG2
o
PHONE:
..L . ".l! : ".J" ~ ..; \; ,_, _'
FAX.
S381^t:!3S Alii':rlf'\jI;\!D~.J .X) JdJO
CITY:
, ~ - .
SUO!lgln6eh~~11'i'~~'~~)~:~!~d3~'~_i~' r;{' +:.t8fC;ns
1 ("\ I,'" r "" ,~, I ,,"i" -,';_.r~
~ -
ZONING:
~
SECTION: /
-L
SQUARE '2 ~
FOOTAGE: /"}.5 2
TAX MAP PARCEL #:
PLUMBING CONTRACTOR:
F V'-/' I {"r tA--!t"
Plumber's Indiana State Li nse #:
/(IT 70 7
/
Whic~umbing codes will be applied to the construction:
G2rlntemational Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
~RAWLSPACE 0 POST & BEAM PIER
~B 0 BASEMENT (WALKOUT:_Y ~
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is valid only if construction commences within 180
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, enlargemenr, relocation, or alteration of a structure, or any change in the use of lalld:,?~ s.tructures
requested by this application w:ill comply with, and conform to, all applicable laws of the State of Indiana, and the ~Zoning Ordinance of Carmel India9~ -:I~~~~;(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 furHi~i c~rtif{diat 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 Certifi~1ie of:
Occupancy has been issu by the Department of Commuruty selVlce~s, C el, Incllana_
, ~ L.. /It. 0 CL 7- / Fa 7
p t Date
OFFICEUSEONLY:******************************~~********************~**~**~********************
NSPECTIONS REQUIRED: Filing Fees: ~'3,7.r;;Jn ,
Base Inspections: c=2..3 0 . 00 # Charged Re-
Reviews
....55. )0
/ 02 (, I 00
TOTA~: #;;2~oS: 70
P.R.I.F.:
Cert. of Occupancy:
Additional Fees
Rough I
Site
-2-I-tJ/'
Revie
. of Community Services (Date)
S:Permits/formS/IlP RESIDENTIAL
Fee Received by:
Date