HomeMy WebLinkAbout05110053-ApplicationCity of Carmel~Clay Tom~sMp
Additions, Remodels, & Accessory Structures
FAX
PROPERTY
OWNER:
LOCATION
& P:R~O. 3ECT
TNFO.
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COHMISSION / BZA / BPW DOCI(E'T
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC pEP,~TT #'S (IF APPLICABLE}:
PE :~-' IV ' - ;:
C~ NEW STRUCTURE
[] ROOM ADDITION(S)
[] PORCH ADDITION(S)
[] REMODEL
[] ACCESSORY BUILDING
[] DETACHED GARAGE
[] ATTACHED GARAGE
[] DEMOLITION
,N ~ ,
/.~ SINGLE FAMILY
TOWN HOME
TWO FAMILY
# of units:.
MULTI-FAMILY ~
# of Units: ~'~
[] RESIDENTIAL (For
Additions, Remodels, Etc.)
Early Release
Permit: y ~N
Nanufactured
Trusses:
Y /'~ N Sump Pump:
Lot Split:
PHONE
CiTY
FAX
ES-HMATED COST OF CONSTRUCI~ON: ~'~ ;, /~
(EXCLUDING LAND VALUE) ~ ~
i State License #:
Which plumbing codes wll! be applied to the
I~] Intematinnal Residential Code w/Indiana Amendmen~
/(~ Uniform Plumbing Code w/Indiana Amendments
(Mu~-Family Construction Code)
FOU . ONTYP~: (Check all that apply for the new
construction area)
[] CRAWLSPACE [] POST & BEAM
Does any part of the property lie within a special Fh:~:! designaUon area: y 7,. N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory
wltht~ 180 days of the date of issuance of the building l~ermit, and mus~ be comple
i~$uance dare. Cla~s I structore l~ermita are subject to the General Administrative Rules c 675 IAC 12) r
time framea for beginning and completing construction.
I, the under~gned, agree that any construction, reco~t~ction, en~gement, tel .oc. ation,
st~uctores requested by this application will comply w~th, and conform to, all applicable laws of the State of b
Indiana _ 1993' (Z~289) and a~endmemta, adopted under authority of I.C. 36~7 et so:{, General Assembl
thereto. I further cert~y that only kitchen, bath, andfloor drains arecomaectedtothe sanitaxysewer. 1 furthel ~ that theconstructionwillnot be
nsed/or occupied until a ~er~r~cac¢ o£Occup~¢yha$ been issued by ~he Department of Community Services,
OFFICE USE ONLY: ************************--**************************--********
Filing Fees: __~2_'~ · O~) __
INSPECTIONS RE~UtRED: ~ # Charged R~-
Revie~itY Services (Date)
Re~d
Additional Fees