HomeMy WebLinkAbout05060017-ApplicationRECORD:
PROPERTY
OWNER:
LOCAI~ON
& PRO3ECT
TNFO:
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: blew Structures, Additions, Remodels, & Accessory Structures
PHONE FAX
BUILDER'S EHAIL ADDRESS
LOT#
BEST METHOD OF CONTACT:
PHONE FAX
SUBDMSION NAHE SECTION
R UIILrFY
PROVIDER: PROVIDER:
NAblE OF UTILFD' EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA/BIBE DOCKET
NUMBERS; TAC DA'rE-(S); AND/OR COUNTY WELL AND/OR SEPTIC PEP, HIT #'S (IF APPL[C4BLE):
SINGLE FAMILY
TOWN HOME
FOOTAGE:
ESTIFIATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
Permit: Y.~_.N
TYPE :--EM -~ :
ROOM ADDITION(S)
PORCH ADDITION(S)
Whlcll plumbing codes will be
CD Uniform PlumbingCodew/[ndianaAmendments
(blulU-Family Construe°don Code)
FO N :-T~ONTY : (Check all that apply for the new
construction area)
[] CRAWl, SPACE [] POST & BEAM
Lot Split: Y c/N Sump Pump: Y ~/__N ~ SLAB [] BASEMENT
Does any part of the preperty lie within a special Flood designation area: Y~/N WALKOUT:Y N
For. ,Si~. ~e F?ily ~a~qd Two V ~a~il. y dwellings, additions, remodels, and/or~ accessory structure~, this permit is valid onl~
· wathin 180 days of the date of msua.n, ce of the .building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the
msumace date. Class I structure perrmta are subject to the General Adroinistrative Rules of thc State of Indiana (See 6751AG 12) regarding expiration
time frames for beginning and completing construction.
I, the undersigned, agree t.~r a~? co, nstm.c..tion, recon~ttuction, enlargement, relocation, or alteration o£ a sttucmre, or any ch~ange tn the use of land or
srtucmres r,..e..?..~ested by this applicataon will comply with, and coliform to, all applicable taws of the State of Indiarm, and the Zoning ordinence o£ Carmet
Indiana- 1993 (Z~289)andamendments~ad~tedunderauth~tity~f~.C~36-~e~eq~GeneralAssem~y~£theS~a~e~£~ndiana~anda~Actsamenda~ry
thereto. I furt~,~ cer~., that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
used or oc?pxed until a Cett~cate of Occupancyhas been issued by the Department of Community Services Carmel Indiana.
- t
Signature of Owner or Autho~zed Agent
INSPECIIONS REQUIRED:
Upper Footing Lower Footing Under Slab
Rough In Meter Base Final
~Community Services
Base Inspections:
Cert, of Occupancy:
P.R.I.F.:
~ ~ Reviews