HomeMy WebLinkAbout07070210 Application
City of Carmel/Clay Township c:?blbl 77) Permit #:~7 07 o..:z 10
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
SEWER lITlLITY /)", A ^~ . J WATER lITlLITY /7/> I ,ry] J /J
PROVIDER: LLVLI r UL PROVIDER: L..[LJLlI L-L...-<--.
NAME OF lITlLITY EXCAVATION coNTRildillJEl'\.SIlCqJ1)1i'j11?5/@tJ ~Z1!j I3.P.W DOCKET
NUMBERS; TAC DATE(S); AND/OR CO~Ob cr t~~1:lR S~M'lC PER"ti'Jii:S(i~reN
FLOOD ZONE AREA DESIGNATION(S) of State and Local C d gu a Ions
FOR THIS PROPERTY: DEPT OF C 0 es.
TV GNRE.tiI1I1M1tR~~,DlTOWNS
r-L Nev./ .5nJP;JrJ!!l.E
i5-ROOM ADDITYdN(S)
o PORCH ADDITION(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
BUILDER
OF
RECORD:
NAME:
STREET ADDRES
PROPERTY
OWNER:
STREET ADDRESS:
LOCATION
&. PROJECT
INFO:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
Ill) TOWN HOME
b' TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions, Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
_VAN
_V iN
Lot Split:
PHONE:
FAX:
STATE:
ZIP:
FAX:
CITY:
STATE:
ZIP:
ZONING:
SQUARE
FOOTAGE:
~ 7 Lj:;-
UMBING CONTRACTOR:
UL
Plumber's In lana State License #:
/ {XAOYJ:f'l
Which plumbing codes will be applied to the construction:
)D
o
International Residential Code w IIndiana Amendments
Uniform Plumbing Code wI Indiana Amendments
Manufactured
Trusses:
Sump Pump:
FOUNDATION TYPE: (Check all that apply for the new
construction area)
LY_N
_yX-N
o CRAWLSPACE
o POST &
BEAM _PIER
~
SLAB
o BASEMENT (WALKOllT:_V_N )
, r c--' I~' (-,~ ~ I -' II "\\. r;,~ , ~-
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is vaFif.o~y~f con~~l}lctio~~ c?flli1.1?nces~~hin ISO
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy issued) ~thi~;IS months of tlie issuarice date~iqa~'I
structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding'exPiration time frames for begiml!~g l}ll~
completing construction. II r\! i : II 1.11
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or ?-ny:c;hange JtJ-k use-oftYan~@ffil::ructl;1f~ ' !
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the ~ZoniJg Orainance of Carmel Indiana - 1993, (Z~ J I
289) and amendments, adopted under authority of I,e. 36~7 et seq, General Assembly of the State of Indiana, and all Act~~rri~ridatory thereto. _ I further certifyit!:l'!1_t'only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not b~ used ~r occupiid untila"Certificate of I
Gee aneyhas been issue y the De artment of Community Services, Cannel, Indiana. I ' I
. .;- SJ-I/lA/N()N I-IJA/fflIlW- -'j~&7J7-.-J
re of w er or uthorized ent Print Date
OFFICEU5EONLY:****************************************************************************~****
~NS. PECTIONS RE RED' Filing Fees: ~~. ~g
Base Inspections: _
per Foo I,ng ~ r-. CO
. Cert. of OccuRa~cy: ~v ' 'V
~~t7~ P. .I~F.: // ,<, 8--1, 00 Additional Fees
!d/1LlL.- Af.~ <if> /5ljZ, SO
# Charged Re-
Reviews
ReViewed/Approved: Dept. of Community Services (Date)
S:PermitsjFormsjILP RESIDENTIAL
Date
Fee Received by: