HomeMy WebLinkAbout05060135-ApplicationGCity of Carmel/Clay Township b~ [/~ Perm~ #:~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, HulU-Family, & Two Family: New Structures, AddiUons, Remodels, & Accessory Structures
~ PHONE FAX
BUZLDER of qr~.~
RECORD: ~~ '"~/~
I S'IREET ADDRESS CITY STATE ZIP
NAME PHONE FAX
-~/
L~OCAT~ON T # 5UBDMSION NAHE
pRO3ECT __
INFO: ADDRES
~J--'~LfrIL1TY WATER UTILIT~
~ PROVIDER:_
J NAME OF UT~ EXCAVATION CONTRACTOR; PLAN COMMISSION / BZR / ~PW DOC~
~R COUNTY WELL AND/OR SEPTIC PER~IT # S (iF APPLICABLE}:
· N ;= N:
[] SINGLE FAMILY
[] TOWN HOME
[~ TWO FAMILY
# Of= units:__
[] MULTI-FAMILY
y # of Un~:
~ ~IDE~L (~r
Add~ons, Rem~els, Etc.)
~ ~: ~ -~ -:
Ea~y Rel~
Pe~it:
~- -FZMPR '-V:, ~ :
[] NEW STRUCTURE
[]_ ~:~ORCH ADDITION(S)
~'~REMODEL
[] ACCESSORY BUILDING
[] DETACHED GARAGE
~A1-FACHED GARAGE
EMOL1TION
Manufactured
of Owner or Authorized .&gent
OFFICE USE ONLY: ************~
INSPECTIONS REQUIRED:
Which/plumbing codes will be applied to the construction:
(~ZntemaUonal ResidenUal Code w/Indiana Amendments
[] Uniform PlumbingCodew/][odianaAmeodments
(MulU-Family Construd:ion Code)
FOUNDATiON.TYPE: (Check all that apply for the new
[] POST & BEAM
[] BASEMENT
WALKOUT:~
, ~models, and/or accessory structures, this permit is valid only ff construction commences
permit, and must be completed (Cer~lcate of Occupancy issued) within 18 months of the
permits are subject to the General Adminis~ative Knles of the State of Indiana (See 675 IAC 12) regarding expiration
~ane frames for beginning and completing construction,
thaz any construction, reconstraction, enlargememt, tek)cation, or alteration of a structure, or any change in the use of land or
and coliform to, all applicable laws of the State of Indiana, and the ~Zonlllg Ordinance of Ce~'~rnel
~ of I,C. 36-7 et seq, GeneralAssembly of the State o£ Ind/ana, and all Acts amendatm7
that only ldtchen, bath, and £ sewer. I further certify that the construction will not be
/ Services, Carmel, Indian~
# Charged Re-
Reviews
Additional Fees
(Date)