HomeMy WebLinkAbout08010113 Application•``FCity of Carmel/Clay Township Permit #:
RESIDENTIAL RAFROVEMENT LOCATION PERMIT APPLICATION
?aoiaaA. For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF NAME.
r.! l PHONE
?5 FAX.
a
RECORD: STREET ADDRESS: CITY: STATE: ZIP:
VA4 .? BUILDERS EMAIL ADDRESS: BEST METHOD OF CONTACT: I (j (y
PROPERTY
OWNER: NAME:
-fs; iI JE PHONE: FAX:. 9
STREET ADDRESS: CITY: STA y ZIP:
LOCATION
& PROJECT LOT SUBDIVISION NAME:
71 L? SECTION: ZONING:
INFO: ADDRESS OF ONSTRU oN:
1 - >t
C? SQUARE
FOOTAGE: U9 Z-5-
SEWER UTILITY
PROVIDER: C-1-14 y WATER UTILITY
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 PERMT *S (IF APPLICABLE): G
Y (A5 7-0 /J Q I
FLOOD ZONE AREA DESIGNATION(S) /
FOR THIS PROPERTY: (V (? TAX MAP PARCEL *:
Jk SINGLE FAMILY
O TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
O RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit: Y _N
Lot Split: _YN
TYPE OF IMPROVEMENT:
NEW STRUCTURE
ROOM ADDITION(S)
O PORCH ADDITION(S)
C DECK ADDITION(S)
O REMODEL
_ Basement Finish only
O ACCESSORY BUILDING
O DETACHED GARAGE
O ATTACHED GARAGE
? DEMOLITION
Manufactured ,t
Trusses: _Y A N
Sump Pump: -4 Y _N
?FJS%EJ2 ?f?l?Es
Plu bets Indiana State License
Which plumbing codes will be applied to the construction:
A international Residential Code w/Indiana Amendments
? Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
? CRAWLSPACE ? POST & _ BEAM -PIER
? SLAB K- BASEMENT (WALKOUT:_Y_X N )
For Single Family 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 18 months of the issuance date. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 LAC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any construction, reconstructon, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the 'Zoning Ordinance of Carmel Indiana -1993" (2-
289) and amendments, adopted under authority of I.C. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Crrt cate of
Occupencyhas been issued by the Department of Community Services, CarrW, Indiana.
(3i-YK1 &) LOS signature of Owner or Authorl:ed Agent Print
Filing Fees:
OFFICE USE ONLY: *********
Base Inspections: 7 54) # Charged Re-
Reviews
Cert. of Occupancy: ,5"5.5'0
P.R.I.F.: l? aC/. Additional Fees