HomeMy WebLinkAbout05090102-ApplicationIRECORD:
City of Carmd/Clay Tmenship ~/~ Permit #
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Famil~[e}l~ New Structures, AddiUonst Remodels, & Accessory Structures
NAME PHONE' FAX
PROPERTY
OWNER:
PHONE
&PRO3ECT
ZNFO:
SEWER UTILITY ~
SECTION
ZONING:
SQUARE
NAME OF UT~L~ EXCRVAT~ON CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
~ SINGLE FAMILY
[]TOWN HOME
TWO FAMILY
# of units:.____
MULTI-FAMILY
# of Units:
[] RESIDENTIAL (For
Add~ons, Remodels, Etc.)
Early Release
Permit: Y
Lot Split: ~ ~ N
Does any part of the
~ NEW STRUCTURE
[] ROOM ADDITION(S)
[] °ORCH ADDITION(S)
[] REMODEL
[]] ACCESSORY BUILDING
[] DETACHED GARAGE
[] ATFACHED GARAGE
C~ DEMOLITION
Manufactured ~
Trusses: Y N
Sump Pump: '--~Y --N
-, UMBI'NG., -NT -- · ::~-~O O
~[~L~: (Check all that apply for the new
construct]on area)
[] CRAWl_SPACE [] POST & BEAM
[] SLAB ~ BASEMENT
Y ~N
For Single Famil)
issuance date. Cla~ 1 str~c~tre
I, the undersigned, agree that a~
structures requested by tkis;
indiana- 1993" (Z-289) and amendments
thexetu. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer.
u~ or occupied until~ CertfiS'c~te of Occupa~cyhas been issued by the Department of Community Stavices,
Sigff~tuze 6f Owner~or Au~or~ed Adent Print Date
OFFzC~SE ONLY:
ZNSPECTZONS REQUZRED:
g Under Slab
Cert. of Occupancy:
P.R.I.F.:
FiNing Fees: ~
Base Inspections: ~ # Cha~,d Re-
Reviews
Additional Fees
Dept. of Community Services