HomeMy WebLinkAbout05100015-ApplicationRECORD:
PROPERTY
OWNER:
LOCATION
& PRO3ECT
TNFO:
City of Carmel/Clay Tor, wzhip ~ Permit #:
RESIDENTIAL IMPROVEMENT LOCATION P LMIT APpLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
~ , -- PHONE ~, J ,FAX
b'TREET ADDRESS C~Y STATE ZiP
IIJILDER'S EMML ADDRESS BE~T METHOD OF~ CONTACT:
# SUBDMSION NAME SECTION
/ 3 gO Cro x.s
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCK~'T
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEFYIC PERMIT #'S (IF APPLICABLE):
ZiP
ZONIH~t
(EXCLUDING LAND VALUE)
000,
PLUMBZNG CONT -' ----
Plumb(q2? ~~ ~cense #,'"
Residential Code w/Indiana Amendments
E) Uniform Plumbing Code w/indiana Amendments
[] DEMOLITION (Multi-Family Construction Code)
Man. fa_~u__~ ~ ~C{~J]~¢O.~-~: (Check all that apply for the new
Early Release u ~ re. n
Does any part of the property he w~thin__a special Flood design ,~ WALKOUT. Y N
For Single Family and Two Family dwellings, additions, remodels, and/or ~p~p~, l~..,~, ~q~ ~L~gc tion commences
within 180 days of the date of issuazlce of the building l~ermit, arid must months of the
issuance dat~ Class I structure permits are subject to the C~meral AdministrarAve Rules of the S~a (See 615 IAC 12) regarding expiration
time frames for beginning and completing construction,
~. the ,mdamgnad. ~,e ~t any consu~ctior~ r¢cons~uction. ~t~gcmant.
stxuctures ~re~.~ested by this application will comply with, ar<l conform to, all applicable lav~of ~S~ ce of Carmel
Indiana - 1993 (Z-289) and amandments, adopted under authority of I.C. 36-7 et seq, Gen~e~ ~f ~t~b~ a~""""""""""""""""""~FAc~S amendatory
thereto. ! further cer~ that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the constroctton will not be
used or occupied unt~ a CerCL~.~.Ce o£Occotmn¢?has been issued by the Department of Community Services, Carmel, Indiana.
~igna'Eum ot Owner or~AUt~'~-~r~ent Print ~ Date
ZNSPECTJONS REQUZRED: ,nl,~. Jf."/~ - ,~'-~,m # chained R-----------~
Under Slab ~ -- Reviews
P.R.I.F.: AddiUonal Fees
~: Dept. of Comrnunity Sen/ices