HomeMy WebLinkAbout06020012-Application
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City of Carmel/Clay Township ?,-i)\J ~ Permit #OftJO ~ IJO d-.
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER UTILITY
PROVIDER:
NAM~ I
-..J OrC1QN
STREET ADDRESS
571..~
.L
PHONE
5\lS- IS 5
OTY
:fnd J
BUILDER'S EMAlL ADDRESS
NAME
Cqy
LOT #
SUBDMSlON NAME
STATE
-r
~ METHOD OF CONTACT:
~N~
ADDRESS OF CONSTRUCTION
J ,
Ov-t-J
PHONE
'1?~ -'HI
FAX
OTY
STATE
l\J
SECTION
ZONING:
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
TYPE OF CONSTRUcnON: TYPE OF IMPROVEMENT:
gj, SINGLE FAMILY 0 NEW STRUcrURE
8 ~~~hD FOR CONS1~U~~DDmON(S)
#SIIIlIljGtll:10 compliance with aIEi'9~~~%~~DmON(S)
o MULTI-FAMlU\Slale f)rel Locul ceO', S'ACCES~ORY BUILDING
#19~OF c:c;"':fvlUNITY !@:FiliMREDGARAGE
o m~'Q~~~J CL,\Y CPJV~~ GARAGE
, IND(ANA ~ DEMOLmON
PROJECT INFORMATION:
Early Release
Permit:
PLUM
Plumber's Indiana
Which plumbing codes will be d to the consb-uction:
o International Residential Code w (Indiana Amendments
o Unifonn Plumbing Code w(Indiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Manufactured
_Y..!L..N Trusses: _y-LN
-< 0 CRAWLSPACE
Lot Split: _Y _N Sump Pump: _Y ~N 0 SLAB
Does any part of the property lie within a special Flood designation area: _ Y ~N
o POST & BEAM
o BASEMENT
WALKOUT:_Y~N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is valid only if construction 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 General Administrative Rules of the State of lndia.na (See 675 lAC 12) regarding expiration
time frames for beginning and completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or
strUctures requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmd
Indiana -199r (Z,289) and amendments, adopted under authOrity of I.C. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
theret I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
u or c ied u . at' te of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
-=rc;h N R, ~1;V" j" AI 1.1: 1cJ{,
Print Da ,
OFFICEUSEONLY:*************************************************:******~***************
Filing Fees: /-J :1, -'7 <;
INSPECTIONS REQUIRED: ' '----', ~ 0 # Charged Re-
Base Inspections: J --' , ./
Reviews
Cert. of Occupancy:
Upper Footing
Rough In
Lower Footing Under Slab
Meter Base Final e
P.R.I.F.:
(Date)
Fee Received by:
Additional Fees
:y.). ;:25'
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