HomeMy WebLinkAbout05060056-Applicationcity o/ C.,,,,m c .y township
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Sin§le Fomil¥, Multi-I:amil¥, & Two Family: New Structures, kdditions, Remodels, & Acce~o~/$1~uctures
RECORD:
PROPERTY
OWNER:
LOCATION
& PRO3ECT
ZNFO:
NAME . '~- PHONE FAX
STREET ADDRESS CTTY STA'I~
ziP
SUBDb/ISION NAME SECTION
ADDRESS OF CONSTRUCTION
NAME OF UTILTTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA /
NUMBERS} TAC DAT~(S); AND/OR COUNTY WELL AND/OR SEFTIC PERM1T #'S
C) SINGLE FAMILY
C) TOWN HOME
TVVO FAMILY
# of units:
[] MULTI-FAMILY
- - FIMPR '~-M- :
~ NEW STRUCTURE
~,/, #of Units: E~ DETACHED GARAGE
RESIDENT[AL (For
[] AFl'ACHED GARAGE
Additions, Remodels, Etc.) [] DEMOLITION
~.// Manufactured
Permit: ¥ N /~Trusses:
Lot Split: Sump Pump-' Y
Does any prat of the
issuance dat~ Clar~ I structure
timcJ
Plumber':
Which
C] Uniform Plumbing C~dew/Zndlana Amendments
(Multi-Family Construction Code)
FOUNDATI -~ , :-: (Check all that apply for the new
construction area)
[] CRAWLSPACE ~POST & BEAM
[] SLAB /~[~ BASEMENT
Y ~ WALKOUT:__Y N
, th~ permit is valid o~ly ff ennstruction commences
! issued) within 18 months of the
,f the State of Indiana (See 675 IAC 12) regarding expiration
=ompletteg construction.
I, thc undersigned, agree that any construction, reconsuuctim of a structure, or any change in thc use ~f land or
structures r,~e~q~.~ .ested by this application will comply with, and co~orm ,pplicabte laws of the State of Indiana, a~d the "Zoning Ordinance of Cazmel
Incliaz~a - 1993 (Z-289) and amanciments, adopted undex authority of I.C. 36-7 et seq, Genezal Assembly of the State of India~% and atl Acts amendatoty
thereto. I fl~er cer~ that only kitchen, bath, and floor drains aze comaected to the sanita~ sewer. 1 further certify that the construction will not be
~ or og~aypied o£Occu]~z;cy'has been issued by the De]parr. ment of Community Services. Carmel. Indiana.
Slgn~lf~re of Owner er'Authorized A~entPrint . ~Date .
OFFICE USE ONLY: ************************************************************************
Filing Fees: ~
Base Inspeddons: # CJ~arged Re*
Reviews
Ee~e~ Footing Under Slab )~/_ ~0
Dept. of Community Services-- (Date)
Cert. of Occupancy:
P,R.LF.:
TOTAL:
AddiUonat Fees