HomeMy WebLinkAbout05110169-ApplicationFamily: Ne ctures, Additions, Remodels, &Accessory Structures
PHONE FAX
~STATE ZIP
BEST METHOD OF CONTACT:
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OWNER:
INFO:
LOT
SUB,DIVISION NAMEd
OF CONSTRUCTIO~
~HONE
STATE
NAME OF UTILITY EXCAVATION CONTRACTOR: PLAN COMMISSION I BZA / BPW DOCKET
NUMBERSi TAC DATE(S); AND/OR COUNTY WELL AND/OR SEWFIC PERMIT #'S (IF APPLICABLE/:
ON:
~ SINGLE FAMILY
[] TOWN HOME
[]] TWO FAMILY
# of units:
[] MULTI-FAMILY
# of Units:
[]] R ESI D E NTIAL ( F-~-~'~r
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
[] ROOM ADDITION(S)
[] PORCH ADDITION(S)
{]] REMODEL
[] ACCESSORY BUILDING
[]] DETACHED GARAGE
[]] ATTACHED GARAGE
CJi] DEMOLITION
EXCLUDING b
Plumber's Indiana #:
Which olumbing codes will be applied to the construction:
Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE_: (Check all that apply for the new
construction area)
Addit]ona Fees
~ Manufactured ~
_Y'-~--fV~N Trusses: __Y C]~/CRAWLSPACE [] POST & BEAM
Lot Split: _Y VN Sump Pump: __/~ _N [] SLAB C] BASEMENT
Does any part of the property lie within a special Flood designation area: Y ~ WALKOUT: Yi~
For Single Family~ ,odels, and or a~tures, this permit is valid only if construcuon commences
within 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits are subject to the GenerM Administrative Rules of the State of Indiana See 675 IAC 12) regarding expiration
time frames for beginning a*~d completing construction.
structures requested by this application will comply with, and contorm to, all applicable laws of the State of Indiana, and the ZonL~g Ordinance of Carmd
Indiana - 1993" (Z-289) and amendments, adopted under authority of LC. 36-7 et seq, General Assembly of the Scare of Indiana, and all Acts amendatory
thereto, I further cer tiff, that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will nor be
used or occupied, untila CertiFiCate o£Occupanc?has been issued by the~E~epartment of Community Services. Carmel Indiana
/ ~gna~ure'~wne~ or Authorized Agent Print // Date~ l
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Fees: ,,__~7~.~< 0~ dg'~ ~
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