HomeMy WebLinkAbout07080221 Application,., Permit #: V /
City of Carmel /Clay Township
RESIDENTIAL IXfPROVEMENT LOCATION PERMIT APPLICATION
??xofnxp.% For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAM' PHONE: Z 2Z _ FAX:
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RECORD: STREET ADDRESS:
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_ BUILDER'S EMAIL ADDRESS: DE BEST`fROF]'ODPF#CC.CRVICES
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PROPERTY NAME: ' PHONE: WWDI N FAX:
OWNER: ' l? - L-
57R ADDRESS:
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LOCATION LOT #: SUBDM N N9M : SECTION: ZONING:
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INFO: ADDRESS OF CONSTRUCTION:
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FOOTAGE:/ U
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SEWER UTILITY ^ WATER UTILITY
P 0V1DER: ESTIMATED COST OF CONSTRUCROOr : 'may'
(EXCLUDING LAND VALUE) Ic/
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PROVIDER: / GG G
NAME OF UTILITY EXCAVATI CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
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S (IF APPLICABLE):
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #
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FLOOD ZONE AREA DESIGNATION(S)
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FOR THIS PROPERTY: X
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TYPE OF CONSTRUCTION:
O SINGLE FAMILY
O TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
RESIDENTIAL (For
Additions. Remodels. Etc.)
PROIECTINFORMATION:
TYPE OF IMPROVEMENT: PLUMBING CONTRACT
OR:
O NEW STRUCTURE ?
Rl ?Acr - RUC I`I?
O ROOM ADDITION(S)
a?S to q"4t..*.,, oance wdh
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Plumber's Indian
O PORCH ADDITION(S) .,
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of Sete _ _?I
O JPIECK ADDITIO?_S
LD REMODELS O/V p6 glIv? Y - r-GS
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Tfstivrtion:
e
lumbing md?e apphed'ta th
Which
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diaH"-"merid?m nlt's' Ir
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O ACCESSORY BUILDING (
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O DETACHED GARAGE ? Uniform Plumbing Code w/Indii a'Amend ents
O ATTACHED GARAGE
O DEMOLITION FOUNDATION TYPE: (Check all that apply for the new
Early Release Manufactured f
Permit: Y f Trusses: _Y N
Lot Split: Y 4y Sump Pump: Y N
construction area)
O CRAWLSPACE O POST &_ BEAM -PIER
AB O BASEMEN (WAL K0LIT:_Y N )
For Single Family and Tevo Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences wirhm 180
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class 1
structure Permits are subject to the General Adnimistntive Rules of the State of Indiana (See 675 IAC 12) regarding expiration time frames for beginning and
completing construction.
f, the undersigned, agree that any construction, teceastnction,.erlareemen`, relocation, or alterationof a structure, or any change in the use of land orsmctures
requested by this application will complywith, and c x:iLetn o, all applicable laws of the Srate of Indiana, and the `Zoning Ordin2ace of Carmel Indiana -1993" (Z-
289) and amendments, adopted under authority of Lk-136-7 et seq. General Assembly of the State o_ Indiana, and A Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further cer[ that the construction .vill not be used or occupied until a Cert&6 to of
Occupancy:haLbeen issued by the epanme?t of community Services, Carne diana.
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OFFICE USVONLY:
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ECTIONS REQUIRED:
pper Foo Lower Footing Under Slab
ough In Meter Ba Final Si
Rev rove ep . o Community Services (Date)
15/FdmS/L'3 SLDEN L
Filing Fees:
Base Inspections:
Cert. of Occupancy:
P.R.I.F.:
// l ?() z Charged Re-
r' Reviews
S5• SC'
Additional Fees
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