HomeMy WebLinkAbout05030235-ApplicationCity of Carmel/Clay Township
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &Two Family: New Structures, Additions, Remodels, &Accessory Structures
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PROPERTY
OWNER:
PHONE
STATE
BEST MEIltOD OF CONTACT:
~ q~t,~' i 7
LOCATZON
& PRO3ECT
INFO:
SEWER. UTTLTTY
PROV]DER:
BUILDER'S EMA[L ADDRESS
FAX
ZIP
cm' STATE zip
SUBDIVZSION NAME SECTZON ' J ZONING:
WA~ ~ ~// I ~MA~D~C~
PRO~D~. ~//~~LODfNG~ND ~UE)
NAME OF UTILZTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMiT #'S (IF APPLICABLE):
FAMILY
TOWN HOME
(~ TWO FAMILY
#ofU itS.
[] RESZDENTZAL (FOr
Additions, Remodels, Etc.)
p~, -, TN -- __- :N:
TYPE M R:VE, El :
NEW STRUCTURE
[] ROOM ADDITION(SI
PORCH ADDITION(S)
REMODEL
[] ACCESSORY BU[LDING
[] DETACHED GARAGE
[] AI'I'ACHED GARAGE
[] DEMOLTT~OI~
__Y ;~N
Sump Pump:
Plumber'.,
Which plumbing codes win be apl)lie
[] Zntemaflonal ResJdenUal Codew/Zndiana Amendments
[] Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Consi~ucfion Code)
~ TYPE: (Check all that apply for the new
conslzuc~on area)
[] CRAWL.SPACE "~ POST & BEAM
[3 SLAB ~ BASEMENq' /
Does any ~pecial Flood designation area: Y
For Single Family and Two Family dw~gs, add/tions, remodels, and/or acccsso~ s~crur~.2 rJ~s pclTnit is vahd, only j.~ co.n?~, r u.c~on c o?m~c~. ~c cs
wittfin 180 days of the date of issuance of the ~uildrng permit, z~ad .mu. st. be co. mpleted (Certificate of Occ. upancy zssued) wathin 18 m~?nths o~ th,e
issuance date. Class I structure permits are subject to the General Admimstratave Rules of the State of Indiana (See 675 IAC 12) regarctmg exp~ranon
time frames for beginning and completing construction. .
I, the undersigned, agree that any constxuct~on, reconstxuctior~ enlargement, rdo.c.., ation, or a~tsration of a struc~re, or any
stsuctures requested by th~s application will comply w~th, and con~orm to, all applicable hws of the Sta~e o£ indiana, and ~e Zo~ g~ ~mmance or t~armex
in&ana - 1993~ (Z-289) and amendments, adopted under authar~ty o£ I.C. 36~ ~ et seq, General Assembly of the State of indiana, and all Acts amendatory
thexeto. I ~rther cert~ thaz only kitchen, bath, and floor drains a~e connected to the sanitary sewer, I further certify that the construcuon will not be
used or occupied until a Cerr~c~te o£Occ~p~c?has been issued by the Department of Community Services, Carmel, Indiana.
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