HomeMy WebLinkAbout05110118-Application #: i k)l
City of Carmel~Clay Township Permit ~ ] ~
R}ESIDENTIAL IMPRO NT LOCATION PERMIT APPLICATION
For Single Family, Hulti-Family, & Two Family: New Structures, Additions, Remodels, & Accessory ~ructurce
NAME ~ F PH
STREET ADDRESS ~ClTY ~ STATE
PROPERTY PHONE
OWNER:
zip
FAX
LOCATION LOT # SUbDIViSION NAME SECnON ZONINg: ~)
& PROJECT ....... -
SEWER UTILITY ESTIMATED COST OF CONSTRUCT[ON:
PROVIDER: ~,~% 0,.~L,~ (EXCLUDING LAND VALUE ~L ;
~ME OF ~ EX~VA~ON CO~OR P~N COMMISSION. B~ ~PW DOCK~ ~ ~
.uM~; TAC DA~(S); ~D/Og COU~ WELL AND/OR SE~C PERM~ ~ S ~F APPL~B E): ~ ~
~PE :F - N R-~I :N: - PE IMPROVEMENT: PLUMBING ~ONT~OR:
~ SINGLE FAMILY ~NEW STRU~URE
TOWN HOME ~ R~M ADD,ON(S) mber's Indiana S~te Licen~ ~:
~O FAMILY ~ PORCH ADDITION(S)
~ of uni~: ~ REMODEk ~
~ MUL~-FAMILY~ ~ ~ ACCESSORY BUILDING Which plumbinB ~des will be applied to me con~u:ion:
~ of Units:~ ~ D~ACHED GAUGE ~ Intema~onal Residential Code w/Indiana Amendmen~
~ RESIDEN~AL (For
~ A~ACHED GAUGE
Additions, Remodels, Etc.) ~ DENOLI~ON ~ Uniform(Multi.FamilyPlumbingConstrumionCOdecode)W/Indiana Amendmen~
P ;-E i_NF:'RMA~ON: FOUNDA~ON~PE: (Check all that apply for the new
Early ~lea~ ~ A Manufa~ure~
Permit: Y ~N Tru~s: ~Y__N :onstru~ion ama)
Lot Split: Y ~N 3ump Pump:~Y ~N ~] s~BC~WLSPACE ~ BASEMENTPO~ A
Does any pa~ of the p~pe~ lie within a special Flood designation area: Y ~N WALKO~: Y__N
~18~ay~ of the date of issuance of the building perm~. , issued/~thin ~8 months of the
675 1AC 12) regarding e~iradon
~~b~s 1 ~ucture
[, ~e un~crsl~ed, agree thai ~y constr~caon
s=uctut¢s re~es~d by tNs appScadon w~ comply
l~di~ ~ 1993" (Z-289) ~d amendments, adopted und~ authority of [.C. 36~7 ct seq, ; am~dato~
thereto, 1 ~urtbcr certify rh~t m~y ~tchen, bath, and floor drains ~e co~ected to the
used or ~pie~ ~ CetrJfic~re o[Occup~ncy has been issued by e Deparm
OFFICE USE ONLY: Filing Fees: ~~ . ~O
Upper Footing Lower Footing Under S,ab CeR. of Occupancy: ~ & ' O O
~eter
Base
F Additional
S~/For~ESIDENmL (Date) ~ei~d~: ~ [ '