HomeMy WebLinkAbout07090145 Application•: City of Carmel/Clay Township Permit
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
an ` For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER ` Sy ??( CC) (\SXrrlS` PHONE:
8 ICJ (??
p
-
a ??O6 b FAX6??-1 r
OF j
t
I
t
RECORD: STREETADDRESS: CITY: STATE: ZIP:
BUILD 'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
?S) S CG 6 C . C m?l+ C L -0`^'•?
PROPERTY NAME: PHONE:
CZI ?'
d
q(3-??23 FAX:
OWNER: f
STREET ADDRESS: CITY: STATE:
20 D Id9-1,1` CAfvw-e, 95J ZIP:
v 3
LOCATION LOT #: SUBDIVISION NAME: SECTION: ZONING:
r"V
s. eq
& PROJECT
-
INFO: ADDRESS OF CONSTRUCTION:
S 14rm -,i? Too •, e QUUAREE Z Y \'
SEWER UTI
PROVIDER: WATER UTILITY
PROVIDER: ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
'
?
NAME OF UTILITY A N CONTRACTOR; PLAN COMMISSION! BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT VS (IF APPLICABLE): nn FP Q N R 97 N M,
FLOOD ZONE AREA DESIGNATION(S)
I TAX MAP PARCEI.
FOR THIS PROPERTY:
I
TYPE OF CONSTRUCTION:
PE
YG SINGLE FAMILY
O TOWN HOME
? TWO FAMILY
# of units being
constructed at this
time:
O RESIDENTIAL(For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
PLUMBING CONTRA
B
Plumber's Indiana State License
TYPE OF IMPROVEMENT:
Which plumbing codes will be applied to the construction:
O International Residential Code w/Indiana Amendments
O Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
O CRAWLSPACE ? POST & _ BEAM -PIER
Q SLAB ? BASEMENT (WALKOUT: Y_N )
O NEW STRUCTURE
? OOM ADDITION(S)
7 PORCH ADDITION(S)
O DECK ADDITION(S)
O REMODEL
_ Basement Finish only
? ACCESSORY BUILDING
? DETACHED GARAGE
O ATTACHED GARAGE
? DEMOLITION
Early Release Manufactured
Permit: _Y Trusses: _Y_ /
Lot Split: _Y tZN Sump Pump: _Y N/
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is %alid only if construction commences within 180
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the iss c te. Class I
structure permits are subject to the General Adm nistrative Rules of the State of Indiana (See 675 IAC 12) regarding expiration inning and
completing Construction. A
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of.a,5?t. PC ?grequested by this application will comply with, and confom to, all avp!icabie laws of the State of Indian`a' th 666'LsLL of carmel Indiana -1993" (2-
269) and amendments, adopted under authority of IC. 3Cr7 et seq, General Assembly of the Scare of Ind ?; atory thereto. I further rarefy that only
kitchen, bath, and floor damn are connected to the sanitary sewer- I further certify that the construction will not be used or occupied until a Certificate of
Occupsncyhas been issued by the Department of Community Sersices, Carmel, Indiana.
% 'E? -Z) r- °Lp5 L'-ZF `OZ
signature of owner or Authorized 4 dent Print Date
*************s:*************************************,:** *?**** ********.*******
OFFICE USE ONLY:
INSPECTIONS REQUIRED' Filing Fees: n
Base Inspections: 30, 00 # Charged Re
per Lower Footin Under Slab Reviews
Cert, of Occupancy:
h I Meter Base Inal Site
P.R.I.F.: Additional Fees
C m4c) lSs.? 0-5-cr-7
ReviewedlAp roDept. o Community Services (Date)
S:Perndts,1F.si LP RESIDVMAL