HomeMy WebLinkAbout07100151 ApplicationCity of Carmel/Clay Township Permit #:
RESIDENTIAL MYROVEMENT LOCATION PERMIT APPLICATION
.?xoua?.%' For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME: PHONE:
2» FAX:
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RECORD: STREET ADD S: CITY: STATE: ZIP:
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BUILDER'S EMAIL ADDRESS:: BEST METHOD OF CONTACT:
SS 47 17- J
PROPERTY NAME: PHONE: FAX:
OWNER:
STREET ADDRESS: CITY: STATE: ZIP:
LOCATION LOT:: SUBDIVISION NAME: j j `
/Jt? //` t
e
, SECTION: /
o `/ ZONING: -
&PROJECT ,
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INFO: ADDRESS OF CON UCTION::
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e4 Az C!? /?Hal /
1 7!li4/ SQUARE
FOOTAGE: 'UO
SEWER UTILITY WATER UTILITY ESTIMATED COST OF CONSTRUC
(EXCLUDING LAND VALUE) TION: J b
2
7-0
7
PROVIDER: Cr`( (,?YJ PROVIDER: r+ L -
O6
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
OR COUNTY WELL AND/OR SEPTIC PERMIT &'S (IF APPLICABLE):
E
S
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NUMBERS; TAC DAT
(
);
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ROOD ZONE AREA DESIGNATION(S) n TAX MAP PARCEL
FOR THIS PROPERTY: m
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TYPE OF CONSTRUCTION:
O-41'14GLE FAMILY
? TOWN HOME
? TWO FAMILY
# of units being
constructed at this
time:
? RESIDENTIAL (For
Additions, Remodels. Etc.l
PROJECT INFORMATION:
Early Release
Permit: _Y _N
Lot Split: _Y _N
? PORCFYADD]TQONM,,
O DECK ADiirno tit) 40
C,y I
O REMODEL 1? Q/n,,` Ct
? ACCESSORY 8t1?I,YiING?,??
O DETACHED GARAd/1
O ATTACHED GARAGE
O DEMOLITION
Manufactured
Trusses: -Y N
Sump Pump: _Y_N
n'w (r-3'e'
Indiana State License #:
?8A/Y10
"is will be applied to the construction:
Anal Residential Code w/Indiana Amendments
Plumbing Code w/Indiana Amendments
(Check all that apply for the new
n a)
L?CRAWLSPACEE O POST & _ BEAM PIER
U SLAB T3 BASEMENT(WALKOLFF:_Y ?N)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences within ISD
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within IS months of the issuance date. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 LAC 12) regarding expiration time frames for beginning and
completing construction.
1, the undersigned, agree that ary construc-lon, reconstruction, erdargement, relocation, or alteration of a structure, or any change in the use of land or structures
requested lay -his application will comply with, and conform to, all applicable laws of the State of Indiana, and the-Zoning Ordinance of Cancel Indiana - 1993" (7-
289) and amendments, adopted under authonryof I C. 36-7 et seq,Genera) Assembly of the State of Indiana, and all Acts amendatory thereto. I further certili that only
kitchen, bath, and floor drains are connected to the sanitary sever. I further certify that the construction will not be used or occupied until a Certificate of
Occup cyhas been issued bye Department of Community Services, Carmel, Indiana.
ode: d??d' cer -Z y 07
99 rre M Ownxv w Aumoria9Agent P t Date
OFFICE USE ONLY: *********************************x*******************?r **? ****************
NSPECTIO .REQUIRED: Filing Fees:
Base Inspections: # charged Re-
pper Foo ' Lower Footi g Under Slab Revews
Cert. of Occupancy:
Rough l Meter Bas Final Site
P.R.LF.; oZ G 00 Additional Fees
d;w
Reviewed Approved: Dept. of Community Services (Date)
S:Pernns/r«rnsmv RESIDENTIAL Fee elved by: Date