HomeMy WebLinkAbout05030165-ApplicationCity of Carmel~Clay Township permit #
RESIDENTIAL PERMIT APPLICATION
For Single Family, MulU-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of NmE ,~ PHONE
RECORD: ~ 0Yr~ ~-/D- -- ~
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STATE
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ADDITION(S)
Plumber's Xndiana State License #:
ipplied to the construction:
Amendments
Code w/Zndiana Amendments
(Check all that apply for the new
Permit: Trusses:
C CRAWl_SPACE [] POST & BEAM
LotSplit: SumpPump: ,~.__Y N ~ SLAB _~ ~ BASEMENT
Does any part of the property lie within a special Flood designation area: Y _.~N WALKOUT: Y~N
· additions, remodels'and/or accessory structures, this permit is valid only if construction commences
within 180 days of the date of issuance of thc building permit, and must bc completed (Certificate o£ Occupancy issued) within 18 months o£ the
issuance date. Class I structure permits are subject to thc General Adminiarrat~vc Rules o£ the Stare o£ Indiana (See 675 IAC 12) regarding expiration
time frames for beginning and completing construction.
I, thc undersigned, agree that any construction, reconstmctior~, enlargemanc, rdocation, or alteration of a structure, or any _~ ~_gfi in thc use of land or
structures ~u, ested by this application will comply with, and conform to, all applicable hws of the Sram of Indiana, and the Zoning Ordinance o£ Carmd
Indiana - 1993 (Z-289) and amendments· adopted under authority of I.C. 36-7 et seq, General Assembly of the Stste of Indiana, and all Acts amendatoty
thereto. I further certify that only kitchen, bath, and ttoor drains are connected to the sanitary sewer. I further certity that the constructaon will not be
used or ~ccupied until a C~ertificate of Occul~ncyhas been issued by the Department of Community Services, Carmel, Indiana,
$ignatore of OWner or Authorized Agent Print o Date
Filing Fees:
Additional Fees
Community Services (Date)