HomeMy WebLinkAbout05040084-Application , IMPROVEMENT LOCATION PERMIT APPLICATION
Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
PHONE FAX~
oWNER:
LOCATION
& PRO.1ECT
INFO:
SEWER LFI~IJTY
PROVIDER: ~
i SINGLE FAM
Permit:
Lot Split:
BEST METHOD OF CONTACT:
PHONE FA)(
SUBI~IVISION NA~E
ADDRE~,,~ OF CONSTRUCTION
SECTION
FOOTAGE:
ESTIMATED COST OF CONSTRUCTION: ·
(EXCLUDING LAND VALUE)
[ SEPTIC PERMIT #~J (IF APPLICABLE): ~ . ., * ~__
PLUMBING CONTRACTOR:
Plumber's Indiana State License #:
REMODEL
~CCESSORY BUILDING
[] DETACHED GARAGE
[] ATTACHED GARAGE
[] DEMOLITION
Manufactured v/
Trusses: Y _N
Which plumbing code~ will be applied t:~ the construction:
[] International ResidenUal Code w/Indiana Amendments
[] Uniform Plumbing Code w/Indiana Amendments
(MulU-Family Construction Code)
F__OUNDATXON TYPE: (Check all that apply for the new
construction area)
~ CRAWLSPACE [] POST & BEAM
Y v/N Sump Pump: Y ¢ N [] SLAB [] BASEMENT
Does any part of the property lie within a special Flood designation area: Y ,~/ N WALKOUT:_ Y~ N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, tiffs permit is valid only ff construction commences
within 180 days of the date of issuance of the building pernfit, 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 IAC 12) regarding expiration
time frames for beginning and completing construction,
Ii the undersigned, a~ee tliat any construction, reconstruction, enlargement, relocation, or alteration of a st~uct~tre, or any cha~ge in the use of land or
st~mctures ~equested by diis application will comply with, and conform to, all applicable laws of the State of L~&ana, and the ~Zor~g O~ance of Ca,mai
Indiana - 1993' (Z-289) ~md amendments , of LC. 36-7 et seq, General Assembly of the State of Indiana, and ail Acts amendatow
thereto. I farther certify that only kitchen, bath, connected to the sanitary sewer. I further certify that the construction will not be
, Services, Carmel, Indiana.
***************************** ************************
Filing Fees: . ~
OFFICE
Reviewed/Approved: Dept, of Community Services
(Date)
Additional Fees
/