HomeMy WebLinkAbout07120061 Applicationrmit
r ; v City of Carmel/Clay Township Pe
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
owa For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER N \ \\- PHONE: QL1 FAX:
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OF .
RECORD: STREET ADDRESS: CITY:
? STATE: ZIP:
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BUILDERS EMAIL AgDRES?; BE METHOD OF CONTACT:
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PROPERTY PHONE: FAX:
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OWNER:
CITY:
STREET ADDRESS:
7 STATE: ZIP:
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G. Okgb
J1 I i? ` -717(p
LOCATION LOT Y: SUBDIVISION NAME: SECTION: ZONING: <
-1
& PROJECT `
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INFO: ADD S OF CONSTRUCTION: /
SQUAREO
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V1
SEWER UTILITY WATER UTILITY O O ESTIMATED COST OF CONSTRUCTION: ?? 4GG
PROVIDER:
PROVIDER: IXCWpIN6t7tND1>7IIDE1 I? -'??i
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
N SEPTIC PERMIT #5 (IF APPUCABLE): :. `. ` G r•I ??
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NUMBERS; TAG DA TE(S); AND/OR COUNTY WELL A 1
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FLOOD ZONE AREA DESIGNATION(S) ,.,I TAX MAP PARCEL
FOR THIS PROPERTY: U I R I S (1 fl
TYPE F CONSTRUCTION:
SINGLE FAMILY
O TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
0 RESIDENTIAL (For
Additions, Remodels, Etc.)
PR03ECT INFORMATION:
Early Release
Permit: _Y N
Lot Split _y N
`TYPE OF IMPROVEMENT:
W NEW STRUCTURE
O ROOM ADDITION(S)
O PORCH ADDITION(S)
? DECK ADDITION(S)
? REMODEL
_ Basement Finish only
O ACCESSORY BUILDING
O DETACHED GARAGE
'? ATTACHED GARAGE
u DEMOLITION
Manufactured ? ?
Trusses: ?r _N
Sump Pump: _iv/_Y_N
PLUMBING ONTRArT :Tt - - 1111
Plumber's Indiana State L Oise
13
Which plumbing [odes will be applied to the onstru o .
011&emational Residential Code w/Indiana Amendments
O Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new i
construction area)
O CRAWLSPACE Gt,? qpffoaCT9M _P
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For Single Family and Two Family dwellings, additions, remodels, andlor accessorystrict 5{Itks val" 1kOVAS'tfu - within 180
days of the date of issuance of the building perm[, and must be completed (Certificate of tSccupanc)Oz;&&e+ ?eb'€R? - Hsu Class I
structure permits are subject to the General Administrative Rules of the State of Indiana See 675 I &r ? liatio Citag ?V14?gmning and
completing construction. DE tJJ t? *},n? 1 -
1, the undersigned, agree chat any construction, rmcons:ruction, erlatgement, relocation, or alm FA&dcdIs6Y3 c e use of land or structures
of Carmel Indiana-1993" (Z-
recuested by dtis application w411 comply with, and confontt to, all applicable laws of the State o a, and the -Zoni We
289) and amendments, adopted under authority of IC. 36-7et seq, General Assembly of ze Scare of Indiana, and 111 Acts amendatory [hereto. I further certify that only
kitchen, bathh, and flout..r?tt{{..ias am connected to the sanitary sewer. 1 further certif}• that the construction will not be used or occupied until a CrrtiBeate of
Aeettpancy p;.s been iXly¢ 4Department of Community Services, Carmel, Indiana.
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Date
OFFICE USE ONLY: *******xxxxx***xx*x*x*xxxx******x*xxx*xx**x**x***x**x* *::tY*xxxxxxxx*x?*x***a*
Filing Fees:
NSPECTIONS REQUIRED: ?J
Base Inspections: # charged Re-
Upper Footing ower Footing nder Slab S O Reviews
Cert. of Occupancy:
Rou h In ter Base inal Site /y
g P R I F: 02 6 V C? Additonal Fees
IOTA D
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?' ors a Irp / 'Z- 07
Reviewed/Ap oved: Dept. of Community Services (Date)
S:Pa IFonnsi[LP RESIDVMm Fee 0. v: \ +?? ?? Date