HomeMy WebLinkAbout07110162 Applicationi r Permit #: ??d b
City of Carmel /Clay Township
RESIDENTIAL IlVOROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME. PHONE: FAX:
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OF
RECORD: STREET AD CITY: STATE: ZIP`
72j_ ? dew, /Z Y L)
BUILDER'S EMAIL ADD
RESS:
-L?ST.ME?T}1Df)b??A.'f.ST l1CTlON
/
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C ADJOC! i0 CO :18ry! 1/ro i
PROPERTY NAME: PHONE: of Sla1e and Lrpal Coero?.
DEPT OF CO
A
OWNER: M
MUNI IY SCR
9TATF:,
STREET ADDRESS: ; CARMEN / Y TOWNSTiIP
I
,
iNDIANA.
LOCATION LOT t: , SUBDIVISION NAME: SECTION: ZONING:
- Z-
& PROJECT
a_ u v
INFO: ADDRESS OF CONSTRUCTION: /
- SQUARE
FOOTAGE: y7-ff
?? G ll1
7 e
1377
SEWER UTILITY
CT WATER UTILITY /S7
PROVIDER: ESTIMATED COST OF CONSTRUCTION:
/ U0
(EXCLUDING LAND VALUE)
-a
PROVIDER:
,c
4 6 a
d.
-
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT a'S (IF APPLICABLE): - Ca zap fi-P
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY: P•
I
sr
Il / i.
TYPE O CONSTRUCTION:
SINGLE FAMILY
O TOWN HOME
? TWO FAMILY
Ar of units being
constructed at this
time:
0 RESIDENTIAL (For
Additions, Remodels, Etc.l
PROIECT INFORMATION:
Early Release
Permit:
Lot Split:
TYPE OF IMPROVEMENT:
NEW STRUCTURE
O ROOM ADDITION(S)
O PORCH ADDITION(S)
O DECK ADDITION(S)
O REMODEL
_ Basement Finish only
O ACCESSORY BUILDING
O DETACHED GARAGE
O ATTACHED GARAGE
O DEMOLITION
Manufactured
Trusses: N
Sump Pump: _Y N
PLUM B NtkACOf3R VNYYLJ L S06`
Plumber's ZR/{71
Which plumbing codes will be applied to the rnnstruction:
l ntemational 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 O POST & _ BEAM -PIER
( B 7e?'BASEMENT(WA1_K0UT: Y ,- )
Y N
_Y _,/N
For Single Family and Two Family: dwellings, additions, remodels, and/or accessory structures, this permit is valid 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 issuance date. Class1
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 any cons ;vcdon, reconstruction, enlargement, relortior., or alteration a: a structure, or any charge in the use of land or structures
requested by this anplicaticn will comply with, and conform to, all applicable laws of the Stare of Indiana, and the -Zoning Ordinance of Carmel Irdiana -1993' (Z-
289) and amendments, adopted under authority of I.C. 36.7 et seq. General Assembly of the State of Indiana, and all Acts amendatory thereto. 1 further certify that anly
kitchen, bath, and floor drains are connected to the sanitary sewer. I Further certify that the construction will not be used or occupied until a Certificate of
Occupancyhas been issued.by the Department of Community Services, Indiana -14
Signature of owner or Author'¢ed ig+ j / Print Date
OFFICE USE ONLY: ************************************************************x *****x****:x*...:
INSPECTIONS RE UIRED: Filing Fees:
Base Inspections: c>2fQ ,]d chargedRe-
Upper Footin wer Foot g Under Slab ?S Reviews
Cert, of Occupancy:
ug In r Base F al
P. R.I.F.: Additional Fees
Fee Received by: veyc