HomeMy WebLinkAbout07080083 Application
11f!1J .~ II (1 DOt) '1
City of Carmel/Clay Township Permit #J}7 Du Tt]
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
,
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
STREET ADDRESS:
LOCATION
&. PROJECT
INFO:
LOT #:
SEWER UTIlITY
PROVIDER:
PHONE:
FAX:
t7 '1-00 57
/\.Ie
/M..J
GAM~ A-J
cm:
SUBDIVISION NAME:
5
UARE . ~
OO()
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I aZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR CQUNlY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATlON(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
,.d---RESIOENTIAL (For
v Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
Y VN
yJ"N
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
~OM ADDITION(S)
o PORCH ADDITION(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
PP e
o International Residential Code w!Indiana Amendments
o Unifonn Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM ~PJER
o SLAB 0 BASEMENT (WALKOUT:~Y----.!N)
Manufactured
Trusses:
Sump Pump:
Y ./N
Y .IN
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!
structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning f<l1d
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 ~Zoning Ordinance of Carmel Indiana - 199r (Z'
289) and amendments, adopted under authority of l.c. 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
Occup:mcyhas 'ssued the Department of Community Services, Cannel, Indiana.
'6'--- ;(Y/ff>....... 1t4$h~h
Upper Footing Lower Footing Under Slab
S Meter Base
tilL . .
Reviewed/Approved: Dept. of Community Services (Date)
Print
1'-10-0 -"7
Date
Base Inspections:
# Charged Re-
Reviews
Cert. of Occupancy:
S;Permits/Forms/ILP RESIDENTIAL
~
Site
P R I F . . Additi?i:'BI Fees
..... 33~ 00
L _ /TqIAL: .-$
Z/d~;;5) @ ~~
Fee Received by:
Date