HomeMy WebLinkAbout07080080 Applicationat CI„y
City of Carmel/Clay Township Permit #:
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of NAME PHONE
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d FAX
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RECORD "
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STREET ADDRESS CITY STA
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BUILDER'S EMAIL ADDRESS BEST METHOD OF CONTACT:
PROPERTY NAME ` PHONE
S FAX
OWNER: cT vw e
STREET ADDRESS CITY STATE ZIP
LOCATION LOT s SUBDIVISION NAME SECTION ZONING: n(? ??}} (
& PROJECT
INFO: ADDpR> ss OF C N ON,
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FOTAG /
FOOTAGE: TL1O
SEWER UTILITY WATER LITY ".:' J -may OF CO ON:
PROVIDER: -- -?-D PROVIDER:
j (EXCLUDING LAND VALU
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
OR SEPTIC PERMIT #'S
NUM
S
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R
OUNT( WE
ANO
IF
PLICABLE
1 D? Lam/!`
1C
BER
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AC DATE(S); AND/O
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TYPE OF CONSTRUCTION:
;<, SINGLE FAMILY
`? TOWN HOME
O TWO FAMILY
# of units:
O MULTI-FAMILY
# of Units:
O RESIDENTIAL (For
Additions, Remodels, Etc.)
PROIECiINFORMATION:
Early Release
Permit: _Y _N
Lot Split: _Y _kLN
TYPE OF IMPROVEMENT:
NEW STRUCTURE
O ROOM ADDITION(S)
O PORCH ADDITION(S)
? REMODEL
O ACCESSORY BUILDING
O DETACHED GARAGE
D ATTACHED GARAGE
O DEMOLITION
Manufactured
Trusses: Y N
Sump Pump: Y _N
PLUMBING CONTRA W'bR: V V u u CUD/
?i ce binvl
Plumber's Indiana State Lic is vJ
io'0t175
Which plumbing codes will be applied to the construction:
? International Residential Code w/Indiana Amendments
Y Uniform Plumbing Code w/Indiana Amendments
(Mull-Family Construction Code)
FOUNDATION TYPE: (Chedc all that apply for the new
construction area)
O CRAWLSPACE O POST & BEAM
? SLAB BASEMENT
woes any part or me property He Wlmin a special rIODo nation area: _T VIV WALrUU I :_r_ IV
40, =
For Single Family and Two Family dwellings, addict essory structures, this permit is valid only if construction commences
within 160 days of the daze of issuance of _ ust be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class 1 structure pe eral Administrative Rules of the State of Indiana (See 675 LAC 12) regarding expiration
amen for beginning and completing construction.
I, the undersigned, agree that co . , recd Ncdom enlargement, relocation, or alteration of a structure, or any change in the use of land or
structures requested by this applies n will comply with, and conform to, all applicahle laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993" (Z-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 only kitchen, barb, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
used or occu ied until a ttBcar of pancyhas been issued by the Department of Community Services,,CCarmel, Indiana.
zy-, 1:61?i S+?A fiF?R . 11Z?5 £5 q IO
glbnatureof Owner or oraed Agent Print Date
OFFICE USE ONLY:******************************************** *************************
INSPECTIONS REQUIRED: Filing Fees: T ?? ? . J 0
Base Inspections: 8 7 ?f/ # Charged Re-
Upper Footing Lower ootirfg l Under Slab Reviews
?? Cert. of Occupancy: SS ? 0
Rough Meter Base Final Site
P.R.I.F.: Additional Fees
TOTA01 ?d . D
?tiz?l? SEt2 5-13-a7
Reviewed/App ved: Dept. of Community Services (Date)
S:Pe'mlWF0r,7W1P RESIDEtRIAL Fee Recehled :