HomeMy WebLinkAbout05060009-ApplicationCity of Carmel/Clay Township
RESiDENTIAL IMPROVEMENT LOCATION
For Single Family, Hulti-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
RECORD:
PROPERTY
OWNER:
LOCATION
PHONE FAX
OTY ST~ ZIP Ct~
BEST METHOD OF CONTACT:
& PROIECT --
INFO:
p · ~ · (EXCLUDING LAND VALUE)
~OF UT~UTY EXCAVA'I~ON CONTRACTOR; PLAN COMMISSI / BZA / ~ DOCKET
~ COUNTY WELL AND/OR SEPTIC PERMIT #'S {IF APPL~CABL~:
- :N : ' : --:-- F - :V -= :
~ SINGLE FAMILY [] NEW STRUCTURE
~]- TOWN HOME
TWO FAMILY
# of units:
MULTI-FAMILY
# of Units:
RESIDENTIAL (For
Add,ons, R~els, ~c.)
Early Rel~
NAME PHONE FAX
0v3,
crrY
LOT h ~ SUBDIVISION NAME
; OF CONSTRUCT[ON
SE~ON~
SQUARE
FOOTAGE:
[] ROOM ADDITION(S) Plumber's Indiana
P
ORCH ADDITION(S)
REMODEL
[] ACCESSORY BUILDING
[] DETACHED GARAGE
[] ATTACHED GARAGE
[] DEMOLITION
[] Uniform Iqb~b~l~itl~a~mendments
~L~q~rr~,~ Lg~Ty SERVICES
~on a~) iNDiANA
~ C~W~PACE ~ ~ & B~
~ S~B '~ ~SE~E~
Manufactured
N ~ N
Permit: Y N Trusses:
Lot Split: Y Sump Pump: Y N
Does any part of the property lie within a special Rood designation area: X ..,~_N WALKOUT: Y N
For St~g)e Fam~y ~md Two Family dweIl~g~, adoptions, z~mod, ds, ~md/or accessory st:uc~es, t~ petmk ts vaItd o~¥ ffco?.t~.ct~oa commeaccs
w~tI~.t~ ],80 da¥~ oE t~ date o£ ~ssua~c¢ o£ the bt~lcIL~g l~n~tt, a~cl must be
~ce date. ~ ~ st~c~ ~ ~e subj~t to tb~ ~act~ A~t~st~dvc ~ o[ ~e S~tc oE ~a~a (S~ ~75 IAC ~2) ~g~g ~o~
~e ~ Eot ~g ~d com~g co~cdoa.
~. of Occupant:
. } P.R.I.F.: Addi~onal F~