HomeMy WebLinkAbout05090158-ApplicationCity of Carmel/Clay Township Permit #:
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
PHONE
BEST MEIHOD OF CONTACT:
PROPERTY Moue Fax
OWNER:
LOCATZON
& pRO3ECT
INFO:
SUBDWLSION NAME
ADDRESS OF CONSTRUCTION
SEWER Lrr[L[TY
PROVIDER: PROVIDER:
NAME OF UTILITY EXCAVATION CONTRACTOR
NUMBERS; TAC DATE(S); AND/O~
' Plumber's Indiana State License #:
[23 RESIDENTIAL
EaHy Release
Permit:
ntplumbing codes will be applied to tee construction:
emaUonal Residential Code w/Indiana Amendments
[] Uniform Plumbing Code w/Zndiana Amendments
(Multi-Family Construction Code)
~ TYPE: (Check all that apply for the new
con_.st~rucUon area)
~ CRAWLSPACE [~ POST & BEAM
(~ SLAB [] BASEMENT
Does any Flood designation area: _Y ~/N WALKOUT:_ Y N
md/or accessory structures, this permit is valid only if construction commences
must be completed (Ce2tificate of Occupancy issued) within 18 months of the
ubject to the General Adminlstrat/v¢ Rules o£ the State of Indiana (See 675 IAC 12) regarding expization
time frames for beginning and completing construction,
1, the undersigned, agree that any consl~uction, teenns~mc~ion, enlargement, rdocatien, or alteration of a s~ucmre, or any change in the use of land or
su~acmtes ~te..qu. ested by fids application wilt comply with, and conform m, all applicable hws o£ the S~ate of Indiana and the 'Zoning ordinance of Carmel
Indiana- 1993 (Z-289) md amandmen~s, adopted under authority of I.C. 36-7 et seq, C~meral Assembly o£ the State o£ Indiana. and all Acts mendatory
thereto, lfurthercertifyr_ha:onlykitchen, bath, anctfloordranis ate connected m the sanitarysewer. I further cezd/ythat theconstructionw/llnot be
Used or occupied until a C¢~c~cate o£Occul~ancj~has been issued by the Department of Community Services. Carmel. Indiana~ ~ ·
Pdnt ~ ~ Date
Under Slab
Cert. of Occupancy: ___.:
Site P.R.I.F.: ./_~, 0 0 Addition~lFees