HomeMy WebLinkAbout05060068-ApplicationCity of Carmel~Clay Township perm~ #:
R SIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, AddiUons, Remodels, & Accessory Structures
BUILDER of
RECORD:
~ROPERTY
OWNER:
PHONE FAX
LOCAl/ON LOT # SUBDIVISION NAME
m PROJECT
INFO: ADDRESS OF C
PHONE FAX
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCXET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICA~BLE):
[] TOWN HOME
[] TWO FAMILY
# of units:__
[] MULTI-FAMILY
# of Units:_
[] RESIDENTIAL (For
Additions, Remodels, Etc.)
- - -F I =- V: MENT_:
~ ROC)M ADDITION(S)
~ ~aORCH ADDITION(S)
~lanufactured
Residential Code ~
Code w/Zndiana Amendments
(Check all that apply for the new
~ssuance date. Class I structure l~rmits are subject to the General Adm~srxative Rules of the State of Indians (See 675 1AC 12) regazding expiration
t~ne frames for beginning a~d completing construction.
I, the undersigned, agree [hat any construction, reconslxucdo~ enlargemenr~ relocation, or alteration of a sla'ucmre, or any change in [he use of land or
structures requested by this application will comply with. and conform te, all applicable laws of the State of indiana, a~d thc 'Zoning Ordiramce of Carm6
indiana - 1993" (Z-289) and amendments, adopted under authotity of I.C. 36-7 et seq, GeneralAssembly of the State of indiana, md all Acts amendatory
thereto. I further certify that only kitchen, bath, and floor drains are connected to [he sanitary sewer. 1 further certify that the construction will not be
used or, occupied until a~Ce~'c~¢ o£Occntxancyhas been issued by the Department of Community Serrices, Carmel, Indiana.
OFFICE USE ONLY: ********************************************~-~*~**`**`~*****`~`~*`?~****************
· Filing Fees: ' : - '~'
INSPECT/ONS REQUIRED· ? :- - -~q --
Base Inspections: ~ # c.~_ ar~ed Re-
Upper FooUng Lower Footing Under Slab ~ ~ Kewews
Cert, of Occupancy: __~
Site
P.R.I.F.: Additional Fees
(Date)
, I ';Revi~w~ed/Appmved: D~pt. of Community Services
TOTAL: