HomeMy WebLinkAbout05080276-ApplicationOCity of Carmel/Clay Township Permit
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUZLDER of .~E F~X
STREET ADDRESS , --
BUILDER'S EMA~L ADDRESS
-- --' I PHONE
PROPERTY ~mE FAX
OWNER: ~_~ 45
LOCATION tOT # SUBDMSION NAHE SECTION ZONING:
& PROIECT __ __ __
--' ' - --" : TYP-= F - R-VEM:- :
[] SINGLE FAMILY
(~) TOWN HOME
~ ~O FAMILY ot S~ ~ ~R6H~ADD~(S)
UL~-FAMIL
· of Uni~:*-'
~ R~IDE~ (~ ~ ~A~ED GAUGE
Rem~els, Etc.) ~ DENO~O~
PLUMBZNG CONTRACTOR:
Zntemational
Uniform
(Multi-Family
Manufactured
Permit: _Y N Trusses: Y _N const~uction area)
.,~ CRAWLSPACE [] POST & BEAM
Lot Split: _Y N Sump Pump: Y N [] SLAB [] BASEMENT
property lie within a special Flood des'Lgn tion .area: _Y N WALKOUT: Y N
For Sta~e ]Fa~y a. nd Two Family dwe]]tags, ac~itioas, remodels, aad/ot accessory s~-ucmr~s, this pe~rmit is ye. ltd only LF coasttucdon comme~c.~s
within 180 days o£ thc dar= o£issua~c= o£ thc butkitng ~n~tt. and must be comp]=ted (C~car.= o£ Occupa~acy issued) w~tMa ~8 mouths o£ thc
issuance date. Class ! st~ucmt~ permits am subj~c~ to the G~¢r~] AdmL~stradv¢ Rules o£ thc State o£ !~ctt~aa (Se= 675 [AC [2) tegatdiag cxpt~ado~
dmc £ra~es £o~ b~mag aad completing co~stmcdoa.
L thc uadetsigned, agt~ tha~ a~y co~s~¢do~, z~com~ucdo~, ~g~m~c, ~-Joca~o~, ot akct ado~ o~ a s~uc~u~, ot a~y c~a~g¢ ~ r~¢ u~ o[]~d oz
~ o~f~[~ ~ aFl. re o[~,~cx~ ~m i~ by ~e D~t of Com~mty Sedco, ~d, ln~m t /
Rough 'tn Meter Base Final
~munity 5ervi
P.R.I.F.: AddiUonal Fees