HomeMy WebLinkAbout06010108-Application
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City of Carmel/Clay Township Permit #: O~~
RESIDENTIAL IMPROVEMENT LOCATION RMIT APPLICATION
For Single Family, Multi-Family, It Two Family: New Structures, Additions, Remodels, It Accessory Structures
BUILDER of NAME
RECORD:
PROPERTY
OWNER:
NAME
STREET ADDRESS
. aPt
FAX
CITY
STATE
ZIP
LOCATION
It PROJECT
INFO:
LOT # /6 SUBDMSION NAM)X
ADDRESS OF CONSlRUCTIQ
SECTION I
ZONING: I? -2-
SQUARE ?
FOOTAGE: /.D-:S-
SEWER UTILITY
PROVIDER:
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCJ<Ef
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
PROJECT INFORMATION:
Early.Release L Manufactured CltIon" area)"'" c' ':~~~~ apply for the new
Permit: _Y _N Trusses: j;3f~~wrs.P.A~~ \1M "1 Ed,~~gf:r~EAM
Lot Split: _Y VN Sump Pump: _Y _N 0150:8;1::11\'] ;=tlf:':;i_C~~~
Does any part of the property lie within a special Flood design~1.&\f: c~Jr"Vv1 ~ Y' 0 E:i\NiAtKfuT=-
\"..:,," ",-ttl__
For Single Family and Two Family dwellings, additions, remodels, and/or a~ry structures
within 180 days of the date of issuance of the building pennit, and must be completed (Certifi
issuance date. Class I structure pennits are subject to the General AdIninistrative Rules of the State
time frames for beginning and completing cons~ctio
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a s
structures requested by this application will comply with, and conform to, all applicable laws of the state of
Indiana -1993w (Z-289) and amendments, adopted under authority of I.c. 36-7 et seq, General Assembly of th
thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I furtb
used or occu ied until a C. . cate of Occupancy has been issued by the Department of Community S
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OFFICEUSEONLY:************************************************************************
Filing Fees: 17 36, )"0
INSPECTIONS REQUIRED: . dG '7 "----0 # Ch ed R
(U -- ~ Base Inspections: /, :::> arg e-
Upper FOOtlni:5LOwer FoOtin Under Slab ...... I ----0 Reviews
Cert. of Occupancy: '5:>
gh P.R.I.F.: / L:J- t j /0" Additional Fees
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Fee Rece by:
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
Sign
TYPE OF IMPROVEMENT:
~ NEW STRUCTURE
o ROOM ADDmON(S)
o PORCH ADDmON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
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Which plumbing codes will be applied to the construction: .'
~ntematlonal Residential Code W Ilndiana Amendments
o Uniform Plumbing Code w/lndlana Amendments
(Multi-Family .Construction Code)
PrInt
!-20.-fJ-6
oate
Cf/\
Reviewed/ proved: Dept. of Community Services
S:PermIts/Fonns/ILP RESJDENTlAl
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