HomeMy WebLinkAbout07060272 Application
City of Carmel/Clay Township Permit #:~.?1
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Struct~res
,
,
BUILDER
OF
RECORD:
NAME:
STREET ADDRESS:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
SEWER UTILITY
PROVIDER:
'/?Mb-C
NAME OF LfT1lfTY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
FOUNDATION TYPE: (Check all that applll for the new
construction area) p,\.lCiION
~ CRAWUi~~ C~~1~d'g\l\a\i~grM _PIER
. ~"-I"D l"" '1'1,\11 a
p,t::UI'o( .S\J(BorrJillia~MEN~IlIA~~ :.-...-:ct N)
,C oC'" ,~
For Single Family and Two Family dwellings, additions, remodels, and/or accessory struetu "i, 's p~~ i'~,L)Il.Mrn'h t ctjp 'r,hin'ISO
days of the date of issuance of the building permit, and must be completed (Certificate of Occ~~y~c(j,~lit'li8 ~11S..){f tll ssuance date. Class I
structure permits are subject to the General Administrative Rules of the St.ate of Indian~ (Se<<\9~13\t h)~e~~~kMOii.time frames for beginning and
compktmgconstructlOn. ~ Of v/';' ,..'.....(f,)lh~'"
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alterGb\ofla structure, or anY~~ge il}'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 Ordin-ance of Carmel Indiana ~ 1993" (Zi
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 ,?nly
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 Certifica.te of
Occup has been issued by th Department of Community Services, Carmel, Indiana.
'J..,;fo C-E,f .( /A/If G-J1/G.te.
Print
.
OFFICE USE ONLY: ******************************~~******** **** * ********"*J*~*/,**m*****************
INSPECTIONS REQUIRED: FIling Fees: rz::. -<:~ I
. . Base Inspections: / '702 ,J ~
pper oot, Lower Footing Under Slab ~ _/I
~ Cert. of Occupancy: ~ '0 ..) v
Meter Base r1'inal Site J
~_ ~ P.R.I.F.: Additional Fees
~ A6'T~ &7!:.5Zl
~~ )/~-
Fee Rec ed by' V Date
FLOOD ZONE AREA DESIGNATlON(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
pi. SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit:
_yAN
_Y+N
Lot Split:
c..v,,-,
Reviewed/ A
G-{;.I<.
L
pUb
c
~c
WATER UTILITY
PROVIDER: c/1-;(' m IS c.....
,9. .NEW STRUCTURE
~ROOM ADDITION(S)
>Cl. PORCH ADDITION(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
ACCESSORY BUILDING
DETACHED GARAGE
ATTACHED GARAGE
DEMOUTION
o
o
J;it
o
Manufactured
Trusses:
_Y4N
_Y~N
Sump Pump:
,
'1.1.~-o
roved: Dept. of Community Services (Date)
S;PermitsjFormsjILP RESIDENTIAL
FAX:
STATE:
ZIP:
BEST METHOD OF CONTACT:
t. o-!%A?... ./:1/ e;. -
Ii ~ iF': C' FAX-"-
'I'r) is ,Q ~ 'I ~r712' /-::;:1'
I. ,. ~_. L.~ ji \:.
1/ n STATE ZIP ! II i I
'/1 ."
I SEWN:
Ilt...
ZONING: J Lj I
SQUARE I
fOOrAGE:--7-7.:r
ESTIMATED COST OF CONSTRUcnON;
(EXCLUDING LAND VALUE)
I.
000
TAX MAP PARCEL #:
PLUMBING CONTRACTOR:
IV/'"
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
o International Residential Code w/lndiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
~ {/2. >/0 '7
Date
# Charged Re-
ReVIews