HomeMy WebLinkAboutApplicationCarmel/Clay
Township Application for Permit No.
Hfld #: Improvement Location Permit Date
Roll File
This permit is valid only if construction is started within 180 days of the date of issuance for residential construction; and for commercial projects, within one (1)
year of the date of issu_ance of the State Commercial Desitin Release. All constmcti0n must be completed ~c/o issued) within 2 .years of the issuance date.
I NAM~ PHONE FAX
.taLI otaT')_ o II 5x7 637/
TENANT NAME
(If applicable)
OWNER
LOCATION
I CITY
NAM~ ' PHONE
STREET CITY
LOT SUBDIVISION
ADD?;F~ONSTR~ON
A. TYPE OF CONSTRUCTION
1. F! Single Family
2. Fl Two Family
3. Fl Multi-Family
4. ~ Commercial / Industrial
5. F! OTHER
(Specify)
g.
STATE ZIP
FAX
727g .5/
STATE ZIP
Co
SECTION
D.
rm¢l c'
SEWER:
1. ~ Public (Name of system
2. Fl Private (County permit #
WATER:
1. [ii[ Public (Name of system
2. Fl Private (County permit #
Do plans incl_~de a porch?
Fl Yes ~EI-No
Type of Foundation
Fl Crawlspace
Fl Basement
I~ Slab
Ko
ESTIMATED COST OF CONSTRUCTION
(Excluding Land Value)
F. TYPE OF IMPROVEMENT
1. ~ New Structure
2. Fl Addition: Porch Room
3. Fl Remodel Fl Commercial Tenant Space
4. Fl Foundation Only
5. Fl Demolition
6. Fl Accessory Building
7. Fl Garage Detached Attached
G. Lot Split YES
H. Flood Zones YES
I. Sump Pump YES
J. Manufactured Trusses YES
Plumbing Contractor
IRC Plumbing Code: Fl Plumber's
Indiana Plumbing Code: F! License #:
NO
NO
NO
NO
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I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana- 1993"
(Z-289) and amendments, adopted under authority of I.C. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further
certify that only kitchen, bath, and floor ~d to the sanitary sewer. I further certify that the construction will not be used or occupied until a
Certificate of Occu~~q~~.i~ied by the ~ment of Community Services, Carmel, Indiana.
J~~ ' INSPECTIONS NEEDED:
~re of Owner or/..~mlh'~~t Footing/Under Slab Rough-In Meter Base
~ / ~,,/ . . _ Site Final CIO
(Print) r ~- ~ - . (Phone Number) ., Sq. l~'t.
Filing Fees:
E-Mail:
Plan Commission/BZA/BPW Docket #'s; TAC Date(s)
· Base Inspections:
Cert. of Occupancy:
P.R.I.F.'
TOTAL:
Reviewed/Approved: Dept. of Community Services
Fee Received by S:Permits/Forms/ILP5-02