HomeMy WebLinkAbout05110115-ApplicationCity of Camel/ Clay Township \~'~ ~' Permit #
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUZLDER of PHONE FAX
PROPERTY
OWNER:
PHONE FAX
LOCA'rZON
& PRO3ECT
SEC'ION
ZONING:
~5~!
; BPW DOC~'T
SINGLE FAMILY
STRUCTURE
#ofU
BUII ~"-
)EMOLTTIOE
Early Release
Permit: Trusses:
Lot Split:
Does any part of the property lie within a special Flood
Plumber's Indiana State Ucense #:
Which plumbing codes will be applied to the construction:
~mattonal Residential Code w/lrndiana Amendments
[] Uniform Plumbing Code w/Indiana Amendments
{MulU-Famiiy ConstrucUon Code)
F: -ND _ :- TYP:: (Check all that a
construction area)
issuance date
time frames for beginnin
[, the under~gned, agree that any constn~cdon, reconstruction, enlargement, relocatio~ or alteration of a structure, or any ~c~ange in the use of land o~
structures ~ested by this application wSl[ comply w~th, and con£orm to, ail applicable laws of the State o£ Indiana, and the Zoning Ordinance of Carmel
Indiana-1993 (Z~289)andamendments~ad~ptedunde~anth~tityof~C~3§~7e~seq~GeneralAssemb~yoftbeState~f~nd~ana~anda~A~t~amendat~ty
thereto. I further certify that only kitche.~, bath, and floor drains axe connected to the sanitaxy sewer. I further certify that the construction will not be
] t~sed-~ occupied u~.q~til a Celc~cacc o~[Occupa~cyhas been issugd~by the Department of Community Services, Carmel, Indiana. j
Sig~tture of O~mer or Allthorlzed Agent /Print Oato
OFFICE USE ONLY: ************************************************************************
Filing Fees: ~
Site
Base [nspecl:ions:
-- Reviews
Cert. of Occupancy:
~R.I,F.: Addi~o~al Fe~s
Reviewed/Approved: Dept. of Community Services (Date)