HomeMy WebLinkAbout08010025 ApplicationCity of Carmel/Cay Township Permit #.
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RESIDENTIAL BOROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER Of NE PHONE FAX
RECORD: e^ ? arv ?r, t7-11$-7r4 I --1tg--7 150
STREET ADDRESS
C)
STATE
?l ZIP
1-4 (.d { ? 0
BUILDER'S R
'S EMAIL ADDRESS BEST METHOD OF CONTACT:
C es+,a z t J-6 0 • quo
PROPERTY NAME PHONE FAX
OWNER: +' 1? 6n e_--ts ?-? 3t 1 - R(43 - S-7-9
STREET ADDRESS QTY STATE ZIP
1 I 01C?Oi Q nd ; L G ' in J v 3 ?-
LOCATION LOTS SUBDIVISION NAME SECTION ZONING:
& PROJECT wom-A land t l
INFO: ADDRESS OF CONSTRUCTION SQUARE
tFc T FOOTAGE:
SEWER UTILITY WATER UTILITY ESTIMATED COST OF CONSTRUCTION: ?
PROVIDER: PROVIDER: (EXCLUDING LAND VALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA J BPW DOG(ET n r 7
NUMBERS; TAC DATE(S ); AND/OR COUNTY WELL. AND/OR SEPTIC PERMIT i'S (IF A PPLICABLE): IJ lJ l?
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
F SINGLE FAMILY
0
TOWN HOME 0 NEW STRUCTURE
0 ROOM ADDITION(S)
a TWO FAMILY 0 PORCH ADDITION(S)
0 # of units:
MULTI-FAMILY 0 RR,
COEL
# of Units: SORY BUILDING
Qk-' J 1,S
0 ilE'I`AtHED GARAGE
0 RESIDENTIAL (For
Additions
Remodels
Etc
) 0' ATTACKED GARAGE
,
,
: •?DEMOLMON
PRO JECT MMRMATION:
Perm it; `7`
Lot Split-
Does any part of tt
N
Pump: Y
PLUMBING CONTRA r,??
Plumber's Indiana Sta Bice
Which plumbing codes will be applied to the construction:
O International Residential Code w/Indiana Amendments
O Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
O CRAWLSPACE 0 POST & BEAM
0 SLAB LJ BASEMENT
property lie within a special Flood designation area: Y N WALKOUT: Y N
For Single TFamily 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 16 months of the
issuance date. Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 TAC 12) regarding expiration
time frames for beginning and completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or
structures requested by this application Krill comply with, and conform to, all applicable laws of the State of Indiana, and the -Zoning Ordinance of Carmel
111 (Z-289) and amendments, adopted under authority of I.C. 36-7 et seq. General Assembly of the 5 Late of Indiana, and all Acts amendatory
the to. I. Fu er erbfy
tt' my kitchen, bath and floor drains are connected to the sanitary sewer- [further certify, that the construction will not be
or P. until - Cate of Occupancy has been issued by the Departmen C:ommuniry Services, Carmel, Indiana
sign. tr or ifiWorizzed Agent Print D
DFFICE USE ONLY: ***************x?*****************a******#?co:*::;*?:****************
INSPECTIONS REQUIRED: Filing Fees:
Base Inspections: ? ?(r _ # Charged Re-
Upper Footing Lower Footing Under Slab Reviews
Cert. of Occupancy:
Rough In Meter Base Final Site
Additional Fees
P.R.LF.:
Qr-A
TOTAL:
?
Reviewed) proved: Dept. of Community Services (Date)
5:PermW V RFS3DENTIAL Fee Receiv bv: