HomeMy WebLinkAbout07120055 Applicationl
City of Carmel/Clay Township
Permit #: 0 / [ A(IL 65
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF NAME%) PHONE: FAX:
31 gL-A4 6 7
RECORD: STREET ADDRE CITY: STATE: ZIP: y
y
?
)
BUILDER'S EMAIL ADDRESS: BEST METHOD OF C NTACT:
PROPERTY NA PHONE: FAX:
OWNER: JJ7
STREET ADDRESS: CITY: ST?
J
ZIP 11603)--
LOCATION LOT SUBDIVISION NAME: SECTION: ZONING:
& PROJECT
INFO: ADDRESS OF CONSTRUCTION:
S SQUARE
FOOTAGE: `O
r
SEWER UTILITY
PROVIDER: CT ?1 I l\ 1 WATER UTILITY
11 n
PROVIDER: ESTIMATED COST Of CONSTRUCTION:
(EXCLUDING LAND VALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARC
FOR THIS PROPERTY:
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
TYPE OF IMPROVEMENT:
O NEW STRUCTURE
O ROOM ADDITION(S)
O PORCH ADDITION(S)
to DECK ADDITION(S)
O REMODEL
_ Basement Finish only
O ACCESSORY BUILDING
? DETACHED GARAGE
ATTACHED GARAGE
C- DEMOLITION
Manufactured
Trusses: _Y N
PLUMBING CONTRA r: ILL, I ) CUU! UI
Plumbers Indiana Star --06e-n_9Z +
which plumbing codes will be applied to the construction:
O International Residential Code w/Indiana Amendments
O Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Chedc all that apply for the new
construction area)
O CRAWLSPACE 67 POST & BEAM -PIER
Lot Split: _Y N Sump Pump: Y _N O SLAB O BASEMENT (WALKOUT: Y_N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction c c ISO
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within IS months of the s I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 LAC 12) regarding expiration ng and
completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a stricture, or an, land or Structures
requelfl?d by this application will comely with, and conform to, all applicable laws of the State of Indiana, and the "Z arrnel Indiana -1993" (Z-
259) a.-r er duress, adopted under authority of LC. 36.7 et seq, General Assembly of the Stare of Indiana, an - a or; thereto. I further certify that only
ki[< hath, and floor drains are connected to the sanitary sewer. I further certify that the construction wil d or occupied until a Certificate of
Om cyhas been issued by the Department of Community Services, Carmel, Indiana
Print
,4z. / 3, 612
*****xxxx*xxx***xxxxx**xxxxxx***xxxxx***xx*xx****xxxx****xx****xxxxx*xxxx***x*xx*
USE ONLY:
INSPECTIONS REQUIRED:
r Slab
Lower Footing Unde
Final Site
97meterBase
Reviewed/Appr ved: Dept. of Community Services (Date)
S:Penniu1Forms/ILP RESMUODAL
Filing Fees:
Base Inspections:
Cert. of Occupancy:
P.R.I.F.:
bv:
r i 5r A Charged Re-
mo Reviews
?• r?jJ
Additional Fees