HomeMy WebLinkAbout05070093-ApplicationPROPERTY
OWNER:
& PRO.1ECT
t'NFO:
SEWER UTILITY
PROVIDER:
City of Carrnel/ Clay Township ~,lu- perm~ #
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, MulU-Family, & Two Family: New Structures, AddiUons, Remodels, & Accessory Structures
~~uj e~ j ~ t~ ..ONE
-Tv z c /J
~STREET ADDRESS ~., I CITY STATE ZIP
~ ElVJAIL ADDRESS BEST METHOD OF CONTACT:
LOT # SUBDZVZSION
7>'_
[] SINGLE FAMILY
[] TOWN HOME
[] TWO[
PHONE
FAX
~/?~
ZONING:
S~UARE
EST[MATED COST OF CONSTRUCTION:
(IF APPMCABLE):
PLUM; NGC: TRA: OR:
Plumber's Indiana State License #:
GARAGE
DEMOLITION
EaHy Release Manufactured
Permit: Y ~[__N Trusses: Y
Which plumbing codes will be applied to the construction:
[] ~nternational ResidenUal Code w/Xndiana Amendments
[] Uniform Plumbing Code w/~ndiana Amendments
(Multi-Family Construction Code)
FOG : ATZO ~ TYPE: (Check all that apply for the new
~onst~ucUon area)
[] CRAWLSPACE [] POST & BEAM
Lot Split: Y ~(N Sump Pump: _Y ;~N ~ SLAB [] BASEMENT
Does any part of the propert~ lie within a special Flood designation area: __Y ~N WALKOLrr:Y N
For Single Family and Two Family dwellings, additions, remodels, and/or ~ccessory structures, this permit is valid only ff to. ns ,m~.ction co. mm~en?s
within 180 days of the date of i~uanee of the building pernut, and must be completed (Certificate of Occupancy xssued) w~thin 18 months oI the
~ssuance clat~ C~ass~st~uctureperm~tsaresubJectt~tbeGenera~Admj~strat~veRu~e~ftheState~f~ndiana(See675~AC~2)regaedingexpira~n
time frames for beginning and completing construction,
I, the undemsigned, agree that any construction, reconstruction, enlargement rel~cauon~ or alteranon of a structure, or any change m the use of land or
sttuctures requested by thla application wilt comply with, a~d c~:form to, all applicable laws of the St, ate ~of, Indiana, ~m~.d ~¢ 'Zo~g,, ,Or, ~din~' anc¢ o,f 5armel
rmdlana ~ 1993" (Z-289) and amendments, adopted under authority of I.e. 36-7 et seq, General Assemmy oI me State ox mmana, an~ aaa ~tcts amenoatory
thereto. I f~rthex certify that only kitchma, bath, and floor drains are connected to the sanitary sewer. I further certify that the constraetion will not be
~ o~ o~=p~ed ~a ~ c~a=~ or o~¢~y ~ ~ m~ed by th~ u~ ~[~0~A,~. ~>~5~ql' iodm~
~o~ ~,to'Z //'//c~'
Lower FooUng ~
~HeterBase ~ Site
~pt. of Community Services (Date)
Cert, of Occupancy: