HomeMy WebLinkAbout07080027 Application
City ofCarmellClay Township Permit #:D7ogrod-.']
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Strubtures
I
I.
BUILDER
OF .
.,
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
SEWER LITILITY
PROVIDER:
11'1 r.
j..l
STREET ADDRESS:
'b. t;"a"11.:: I,
BUILDER'S EMAIL ADDRESS:
NAME:
Dmr eJ St41.lA-iliVv~
C,-1I\.6...t L..'\<.(
STREET ADDRESS:
~<:;i[lj
LOT#:
SUBDIVISION NAME:
UtL~ ~ W
II
ADDRESS OF Ct$';fJN~ ~
\1\.00-
WATER lJT1LfTY
PROVIDER: hl ~
He....
TYPE OF IMPROVEMENT:
TYPE OF CONSTRUCTION:
Iji{. SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
FOUNDATION TYPE: (Check a I th apply for the new
construction area) ~\O
o CRAWLSP~\,) ~& BEAM _PIER
o ~O~~~lt1SNT ~GllJT:_Y_N)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory st~'1tll~~'S .~~~. ~'a'9lUY' n~;r1I~ commences within 180
days of the date of issuance of the building permit, and must be completed (Cer.!!~~ Ef~ c ~ . ~ )~l"-~Q~~~h~ issuance date. Oass I
structure pennits are subject to the General Administrative Rules of the State o~~~~ ~,\'7S: I inae~)ration time frames for beginning and
completing con~on. 0 CO \ _ \ \,)'-'V ~ I
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or aJte!:ifi~ ~ ~ca~~'t5r aJl.~ge in the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the SJ\t.\l ~e~ th\~Wo-;di~ance of Carmel Indiana -1993n (2-
289) and amendments, adopted under authority of I.c. 36~7 et seq, General Assembly of thMt~~iana, and an :Acts amendatory thereto. I further cert:ify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that ~Qpn.struction will not be used or occupied until a Certificate of
Occupancy has been issued by the De artmeut of Community Services, Carmel, IndiaM..
C1.Mk ..Jt (. Cc..-l1c tltJ(/(
o NEW STRUCTURE
o ROOM ADDITION(S)
r;... PORCH ADDITION(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
PROJECT INFORMATION:
~ Manufactured
_Y _N Trusses:
_Y~mpPump:
_Y~
Early Release
Permit:
Lot Split:
_ Y .-..-Ir
Print
PHONE:
FAX:
'82/':;-I?.ll
CITY:
STATE: ZIP:
l h 1{l,.12.~'V
BEST METHOD OF CONTACT:
PHON\< lb-4- _ rl)~ 11
CITY'
U~
FAX:
STATE:
::::l~
ZIP:
L{ V 03)
"'ZOl/I~G,'Q:- ,.[1. l?
___~...: ::...:.:.N ..J
SECTION:
SQUARE
FOOTAGE:
"19/
1\ \ <l....
Plumber's tndiana State License #:
Which plumbing codes will be applied to the construction:
o International Residential Code w IIndiana Amendm~nts
o Uniform Plumbing"Code wlIndiana Amendments
..~ - (0 -01
o.te
/
OFFICE USE ONLY: *******************'**n*****~~* *****.*************i'i****~********************
INSPECTIONS REQUIRED: \ 6 If .~Ifl') ng Fees. / f: 2
. \ (11 Base Inspections: /7.2. <5 {J # Charged Re-
Upper Foo Lower Footmg Under Slab ReViews
Cert. of Occupancy: 6 ','). TO
P.R.I.F.:
Final Site
Additional Fees
C II....:? f1l~. /" <j':-<('-dl-
Reviewed/Approved: Dept. of Community Services (Date)
S:Permits/Form${IlP RESIDENTIAL
r/O-t!)
Date