HomeMy WebLinkAbout05060015-ApplicationCity of Carmel~Clay Township Permit #:
SIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Hulti-Family, & Two Family: New Structures, Additions, Remodels, & Accessory StnJctures
E PHONE
BUILDER'S EHA[L ADDRESS BEST METHOD OF CONTACT:
PROPERTY
OWNER:
SUBDIVISION NAME
LOCATZON
& PRO3ECT
INFO: oF CONSmUCnoN
P~OVIDER: PROVIDEP~
NAME OF UTIIJTY EXCAVAT~Ofl CONTRACTOR; PLAN COMMISSION / BZA / BPW DOC~'T
[] SINGLE FAMILY
[] TOWN HOME
[] TWO FAMILY
'~' RESIDENTI/~L ~;
NEVV STRUCTURE
ROOM ADDiTiON(S)
~A
Plumber's Indiana State License #:
Wh~c~
[] IntemaUonal I
[] Uniform
(Mutt~-Famil
Early Release Manufactured construction
Permit:. y__N Trusses: Y__N [] CRAWl_SPACE -.~~
Lot Split. ~ __N Sump Pump: Y __N ~ SLAB [] BASEMENT
Does any part of the property lie within a $i~cial Flood designaUon ~rea: Y__N WALKOUT: Y N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only ff construction commences
witlfin 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits are subject tu the General Administrative Rules of the State of Indiana (See 675 IAC 12) regarding expiration
time frames for begim~g and completing construction.
I, the undersigned, agree that any constructior~ reconstruction, enlargement~ telocation~ or alteration o£ a sttuc~are, or any cliange ~n the use of land or
s~uctures requested by th~s application will comply with, and co~fform to, all applicable laws of the State of Indiana, and the 'Zoning Ordinance of Carmel
indiana - 1993~ (Z~289) and amendments, adopted under authority of I,C. 364 et seq, General Assembly of the State of indiana, end all Acts amendatory
thereto. I further certify that o~ly kitchen, bath, and floor drains are connected to the sanicm7 sewer. I further certify that the consUuction will not be
used or occupied until a CerrJt~cato of Occupm~cyhas been issued by the Department of Corarnenlty Services. Carmel. Indiana.
SlgnabJre of Owner or Authorized ~gelTt Dat~
OFF~CE USE ONLY:
Upper Footing Lower Footing
Rough ~n Meter Base Final
[Date) --