HomeMy WebLinkAbout07090152 Application9
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City of Carmel/Clay Township
Permit #: 70 qoe elZo
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of ` ?, PHONE FAX
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RECORD: .0
SfATEZIP
STREET ADD
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BU ER'S EMAIL ADDRESS BEST METHOD OF CONTACT;
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PROPERTY E PHONE FAX
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OWNER: -_s
STREET ADDRESS CITY STATE ZIP
LOCATION LOT # SUBDIVISION NAME SECTION
33 l
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INFO: ADDRESS OF CONSTRUCTION
/ SQUARE
FOOTAGE:
SEWER UTILITY CW.
PROVIDER: JiA ?6Lt}I(\?1ti1? WATER UTILITY
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PROVIDER: ?L
L i'1nn ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) ;
, i
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C?1
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4 Co
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION! BZZA I BP
W DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE): l f V
TYPE OF CONSTRUCTION:
d SINGLE FAMILY
D TOWN HOME
D TWO FAMILY
# of units:
O MULTI-FAMILY
# of Units:
0 RESIDENTIAL (For
Additions, Remodels, Etc.)
Early Release
Permit: _Y ? N
Lot Split; _Y ? N
TYPE OF IMPROVEMENT:
CI NEW STRUCTURE
O ROOM ADDITION(S)
? PORCH ADDITION(S)
? REMODEL
O ACCESSORY BUILDING
O DETACHED GARAGE
O ATTACHED GARAGE
? _DEMO) i .. i
Sump
Does any part of the property lie within a
GT 0 2 RECD
/Y _N
Plumber's Indiana State Li se #:
- n, 'IW.hhiich plumbing codes will be applied to the co
'J? Intemational Residential Code w/Indian f
i? Uniform Plumbing Code w/lndiana Amendmeii ,
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the net
construction area)
(J CRAWLSPACE O POST & BEAM
O SLAB D BASEMENT
%;BFep;" _Y /N WALKOUT:_Y ? N
For Single Family and Two Family dwellings, additions, Sfi t9st r 'tHd v ? cb•}n es
19 withi n180 days of the date of issuance of e buildin A lcgm `ry'` c {w] n d i n ntllt3 ?f e
issuance dace. Class I structure permits are subject [o sMt! o?c of Ttl?A6r ( 75 lAC 12) regarding exj(ha ion
time frames for b p e..i c }o?n. EO S '+!)f'?
I, the undersigned, agree that any construction, reconstruction, enlargement, r 0 Y C. or ha? E in the use ot`land or j
rhii
structures requested by this application will comply with, and conform to, all a,(gsys d[ t®p? a.. a. the `Zoning Ordinance of Cam I
Indiana - 1993` (Z-289) and amendments, adopted under authority of I.C. 36-7 et seq, G I .Assembly c of na, and all Acts amendatory
thereto. 1 further certify that only kitchen, bath, and floor drains are connected to ncc sanitary sewer. 1 further certify
u: dor(olecupied{antil a ` tificare olOccupan has been issued by the ?epanment of Community Services, Carmel. Indiana.
1 X?lL) t? ywY \S 'L3 0
5 natu of Own or uthorized Agent Print Date
)FFME USE ONLY: *********************************************/** -***3?***** ****************
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INSPECTIONS REQUIRED: Filing Fees: E"
Base Inspections: 3 0. DU s Charged Re-.
M ng Lower Footing der Slab Reviews
Cert. of Occupancy: ?5 SO
'Meter Ba Final Site
P.R.I. F.: ? ? C iJ Q AddiDOnal Fees
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Ved: Dept. of Community Services (Date)
RESICEImAL Fee a ,N b,