HomeMy WebLinkAbout07080153 ApplicationPermit #: ..,. City of Carmel/Clay Township
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
?rsouna / For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME. PHONE: c FAX:
6 p ?C 2/tlz YG yzZ y
OF
RECORD: STREET ADDR r STATE: ZIP:
BUILDERS EMAIL ADDRESS: BEST METHOD OF CONTACT:
r
PROPERTY NAME: PHONE: FAX:
WNER
:
O
STREET ADDRESS: CITY: STATE: ZIP:
LOCATION - LOT SUBDIVISION NAME: / SECTION
2 ZONING: /
PROJECT Z .
& _
INFO: ADDRESS OF CONSTRUCTION: ?AREt
t
3s
SEWER UTILITY
PROVIDER: C TA (V YdATER UTILITY
PROVIDER: ?? p ?` ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
Qge
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
S (IF APPLICABLE):
ND
WE
OR SEPTIC PERMIT #''
O
LL A
/
NUMBERS; TAC DATE(S); AND/OR COUNTY ?
'S
FLOOD ZONE AREA DESIGNATION(S) TAX M RCEL #: ?'A A
FOR THIS PROPERTY: (R
TYPE OF CONSTRUCTION:
,P---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:
Lot Split:
_Y N
Y _N
TYPE OF IMPROVEMENT:
er NEW STRUCTURE
O ROOM ADDITION(S)
O PORCH ADDITION(S)
D DECK ADDITION(S)
O REMODEL
_ Basement Finish only
O ACCESSORY BUILDING
O DETACHED GARAGE
? ATTACHED GARAGE
? DEMOLITION
Manufactured
Trusses:I N
Sump Pump: Y _N
PLUMBING C NTRACTOR:
Plum er's Indiana State Liven •?,
40
Which plumbing codes will be applied to the wnstruction:
CR-lntemational Residential Code w/Indiana Amendments
O Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE:
construction area)
for the new
For Single Family and Two Family dwellings, additions, remodels, and/or accessory stru ii Wiy.,- W m Gaon commences within 180
davs of the date of issuance of the building permit, and must be completed (Certificate c X( of the issuance date. Class 1
structure permits are subject to the General Administrative Rules of the state of Indiana ( > AC Pt?te frames for beging and
completing construction.? ??\ `_.
I, the undersigned, agree that any, construction, reconstruction, enlargement, relocation, or alterati@r?'' sb iset; or an, ac in the use o_ land or structures
requested by this application will comply with, and conforrn to, all applicable laws of the State of In(Yl a he-Zoning Ordinance of Carrot] Indiana -199Y
299) and amendments, adopted under autho^ty of I.C. 36.7 et seq, General -Assembly of the State ofolr!a, and all Acts amendatory thereto. I further certify that only
la:chen, bath, and Door drains are connected to the sanitary sewer. I further certify that the construction will not he used or occupied until a Certificate of
Occupancyhas been issued b the Department of Community Services, Camtel, Indiana
/2:7j7
Sia&rfure of Ownar Cc A thoricedtAr Print Date
OFFICE USE ONLY: x*x*x*xxx*xxxxx*xx**xxxx**xx**xxx**xxx*xx**xxx*xxxrx xxx *xx**xx*xxx*******+***xx
INSPECTIONS REQUIRED: Filing Fees: j v # Charged Re-
Base Inspections:
pper Footin wer Footing°j der Slab Reviews
J :5-61
?- Cert. of Occupancy:
ough I eter ase ma Site P.R.LF.: 00 Additional Fees
?_ -
o 36 3. -,5-0
RR eded/ Dept of Community Services (Date)
S:Pemuts/FO VILP RESIDER AL Fee Received by: Date