HomeMy WebLinkAbout07120035 Applicationa) 7/C) g,
Y ; mow` City of Carmel/Clay Township Permit #:
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
,,`apwa For Single Family, Town Home, &wo Family: New Structures, Addition Remodels, & Accessory Structures
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BUILDER NAME: ti I PHONE: ? FAX: el el -1 /1) 'n I
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RECORD:
STREET ADDRESS:
CITY: ga
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PROPERTY NAME: 1 4 '
' IN .1\ I P"o"g np
% [f'OWNSHIP
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OWNER W I
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STREET ADDRESS: / l 1 n ft I . ] ??CITY:
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q1 t CvLn RMe 1 A. ZIP:
LOCATION LOT SUBDIVISION NAME: SECTION: ZONIN -/
PROJECT
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INFO: /
ADDRESS OF CONSTRUCTION: I f 't , II' I I ] ?-
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SQUARE +
FOOTAGE: I 1 'Qt
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SEWER UTILITY_
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7- WATER UTILITY
C ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VAL n?
PROVIDER: PROVIDER:
? "L r7 (7)
NAME OF UTILITY EXCAVATION CONT CTOR; PLAN COMMISSION I BZA I SEW DOCKET , u U
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL -ANDJOR SEPTIC PERMIT #5 (IF APPLICABLE):
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ROOD ZONE AREA DESIGNATION(S) =? 1 TAX MAP PARCEL HU DEC U ZOO 77 /,,
TYPE OF CONSTRUCTION:
O SINGLE FAMILY
? TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
RESIDENTIAL(For
Additions. Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit: _Y _N
Lot Split: Y N
OF IMPROVEMENT:
O NEW STRUCTURE
O ROOM ADDITION(S)
O PORCH ADDIrION(S)
? DECK ADDITION(S)
O REMODEL
_ Basement Finish only
O ACCESSORY BUILDING
DETACHED GARAGE
O ATTACHED GARAGE
O DEMOLITION
Manufactured
Trusses:
Sump Pump:
Y N
_Y XN
PLUMBING CONTRA ?
PI b is Indiana State License.#7?_ J/
P/ C '%C G6 Which plum bing codes will be applied to the co strucan:
? International Residential Code W/Indiana Amendments
? Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
? CRAWLSPACE O POST&BEAM-PIER
X SLAB ? BASEMENT (WALKOUT:_Y_N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessorystructures, this permit is valid only if construction commences within IBD
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 pennits are subject to the General Administrative Rules of the State of Indiana (See 675 I.AC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any construction, reconstrxtior, enlargement, relocation, or altemion of a strucrure, or any change in the use of land or structures
requested by this application will comply with, and conf - able laws of the Sure of Indiana, and the -Zoning Ordinance of Carmel indiana -1953" (Z-
289) and amendments, adopted under autho:itv ° . 3Cr7 et scq, General. buy of the State of Indiana, and 2l Acts amendatory thereto. 1(unher certify that only
kitchen, bath, and floor drains are connect o the sanitary sewer. I further car - tat the construc[ion .will not be used or occupied until a Certi6ate of
Occupant as be sued e D astment of Community Services, el, I dfana
-VT
Signature of ovmer or Authorized A _ Print Date
INSPECTIONS REQUIRED: Filing Fees: / d
Base Inspections: ?3O Oy # Charged Ra-
pper Footi Lower Footi Under Slab D Reviews
Cert. of Occupancy: SS- S
Cough In Meter Base Final Site Additional Fees
P.R.I.F.:
Review roved: Deqpt: of Community Services (Date)
S:PeonaslFonnsilLP RESIDENTIAL Fee Recelved by: Date