HomeMy WebLinkAbout08010041 ApplicationCity of Carmel/Clay Township Permit #:, ???0 ?/?
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
?wolaNa. For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME: PHONE: FAX:
OF 4, . I ? .-?
RECORD: STREET ADDRESS: CITY: STATE: ZIP:
L
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
PROPERTY NAME' PHONE: FAX:
OWNER: l 1c.
STREET ADDRESS: CITY: STATE: ZIP:
LOCATION LOT SUBDIVISION NAME: SECTION: ZONING:
& PROJECT
INFO'
• ADDRESS OF CONSTRUCTION: SQUARE
FOOTAGE: >L?
SEWER UTILITY WATER UTILITY M C r ESTIMATED COST OF CONSTRUCTION:
PROVIDER: PROVIDER: (EXCLUDING LAND VALUE) )
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA J BPW DOCKET
IF APPLICABLE):
EPTIC PERMIT *S
(
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR S
FLOOD ZONE AREA DESIGNATION(S) ' TAX M EL
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
$' SINGLE FAMILY
Cl TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
C RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit: _Y N
Lot Split: Y N
TYPE OF IMALOVEMEN
O NEW STRUCTURE
ROOM ADDITION(S)
O PORCH ADDITION(S)
O DECK ADDITION(S)
O REMODEL
_ Basement Finish only
O ACCESSORY BUILDING
D DETACHED GARAGE
C ATTACHED GARAGE
C DEMOLITION
Manufactured
Trusses: Y -N
Sump Pump: _Y _N
For Single Family and Two Family dwellings, additions, remodels, and/or access,
days of the date of issuance of the building permit, and must be completed (Cei
structure permits are subject to the General Administrative Rules of the State of
MB G co*wrog:
9?
pa/
8
4
@ SO'8
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction-
0 International Residential Code w/Indiana Amendments
? Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all
construction area) ??""?? v(
? CRAWLSPpC IN496, M
time
ly for the new
BEAM PIEFj.
nences within 180
that any construction, reconstruction, enlargement, relocation, or alte)® o or gc in the use of land or structures
ion will comply with, and conform to, all applicable laws of the State d the `Zonr g Ordinance of Carmet Ir.diana -1993" (Z-
opEed under authority of I.C. 36-7 et seq, General Assembly of the Sta ndiana, and all Acts amendatory thereto. I further cc.-t* that omy
pins are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
ied by the Department of Community Senices, Carmel,, -ana.
/L'
arled Anent Print woe
*******************************************************?iJ O`****?cf**************
OFFICE USE ONLY:
Filing Fees:
- INSPECTIONS REQUIRED:
Base Inspections: # Charged Re-
Upper Footing ng nder Slab Reviews
Cert. of Occupancy: -- 4
R na Site 11
P.R.LF.: f ? GI r; V Additional Fees
?.. `?, 1 _ t _ sr? r»? TOTAL: X752 ?..?U
Reviewed/Appro d: Dlpt of Community Services (Date) ,
S PermiWFormV" RESIDENTIAL Fee RecqW?b bv: