HomeMy WebLinkAbout06020083 Application
City ofCarmeI/Clay Township t- vVtpermit #: Ob?) ,)(J'f'J63
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, 8. Two Family: New Structures, Additions, Remodels, 8. Accessory Structures
BUILDER of
RECORD:
}\AME
el?6\..E
.,sI&,EET ADDRESS
r.-D.Bv'K
PHONE
CO"-i~RJQ~i fJL
21..2"3 t 4
FAX
'5/7 g2s--DZ2
'1/0 ,'l27
ZIP
'-I~'"22-4
BEST METHOD OF CONTACT:
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CITY
Sf ATE
IN
NbPLS
BUILDER'S EMAIL ADDRESS
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PROPERTY
OWNER:
NAME
tv) M!-IL
STREET ADDRE~
\2\'1K
LOCATION
8. PROJECT
INFO:
lOT #
SB'C6tL> f3PJ.- . N IU-
6\iZNOUt0
PHONE
- l(> 1"'7
CITY
ghoXtJ CAe iw.-t
b{2.ol/ fZ-
FAX
RB1:> &Ol-D
ZIP
D '3 z...
ZONING:..J.:'::.. }
~-,- ~
SQUARE 'z.z..&!>1'!:S
LJ lPo3 L FOOTAGE ~5 /:>.n IC-
ESTIMATED COSf OF CONSfRUCTION, 73 i TV
'3 O,~vD
STATE
\10
l
SUBDIVISION NAME H \ brl
SECTION
ADDRESS Of CONSTRUCTION
\ 1.. \ t1 is .R'f"..t:> 0 D\.. t>
~W
SEWER UTILITY
PROVIDER:
\ZUJ0
:Ii
(EXCLUDING LAND VALUE)
WATER UTILITY
PROVIDER:
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE{S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
'rti RESIDENTIAL (For
f' Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
o NEW STRUCTURE c..p 305oClO:31
o ROOM ADDITION(S) Plumber's Indiana State Licen
,g, PORCH ADDmON(S)(-'~- i"
~ REMODEL 6P6E\III~j
o ACCESSORY BUILDIN~ 'M"flE!lumbing codes will be applied to the construction:
o DETACHED GARAGE H^ Q-rntemational Residential Code wI Indiana Amendments
o ATTACHED GARAGE Il. . ..
O DEMO ITION 0 UnIform PlumbIng Code wI IndIana Amendments
L (Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release V Manufactured V
Permit: _Y.L::!..N Trusses: _Y ~N
Lot Split: _y..J{N Sump pump:-.---,Y)4N. B ~~:L5PACE ~~:E~~M
Does any part of the property li~,~ithin a sp~i:i~IFI~bd;d~~igi;~t;<;.:Ni1<lQ.~ Y v1f WALKOUT: y_4
'-"~~"'i';:':"'... i:,' ,".-"!'..'r..;,..:n,....'..... ,,_..:.H, ". _. . .~ - ~..-, "'-"'_ 1
Fo~ Si~gle Family and Two Fa~i1y dwellings, a~it~ns.:~IR?Pjlt.~zcljpl}~;..fffl~g~y ~iructtir~s.' this Pef~\'i\S ;v~t~C~?~}Y rf_~~.n\~.~~~t:~~~- ~_o.~ln~\~~es
WIthm ISO days of the date of lssuanft}6fpi~~~pcwmJtrt'}rW ~t})~~~]st.ed {CertIficate ofOccuIpancYlssued) Wlthm 18 montHs of the
issuance date. Class I structure per~Fr~s . ~'A.o.t'&"Cl!I\~t!JlAaJntn'fstia~G DISe Stat~ of l~!~~~ (See 675 lAC 12) regarding ~~pirH~on
m.l..MM!dAIi:b.:gl~lt6 ~g:qgj]~uctlon. i I r \ \ c ~nnh . ' I 'I:
I, the undersigned, agree that any construction, reconstructiofNJt\1rAemeRt, relocatlon, or a:tar~Hon of a strucFu?e~ br an~&ge1n the Hie1ffi land I~Fj} \
structures requested by this application will comply \vith, and coJrbYrn'tX~ll applicable laws of the State of In~~n~: 4nd rhe'";"Zoning Ordinance of varmelj
Indiana -1993" (Z~289) and amendments, adopted under authority of LC 36-7 ct seq, General Assembly of the rt~te..bf In~El!..~nd.allActs,amendatory \
thereto. 1 furt~er cem.fy that o~l~' kitchen, bath, and floor drai~s are connected to the sanitary se\ver. t. furthcIjcertifythat the ~onstruction will not be J
used 0 ed untIl a CertIficate of Occupancy has been Issued by the Department of CommunIty Servtes, Carm...:.!:.:r;:!!~____._----_..
) f;,eel'-/l ,4- ;/ U H;J ;z /;l,;'P(Q
o OWner or Authorized Agent Print Date
USE ONLY: **************************~******************~**~~**~*J~**************
Filing Fees: 1i.:2:/L' /_)
INSPECTIONS REQUIRED: '/- A 7 # Ch d
Base Inspections: _ U.'~f/ () arge Re-
Upper Footing Lower Footing Under Slab / Reviews
--- Cert. of Occupancy: '5./ S' ()
~ Meter Base f"';;;'; S~
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Additional Fees
( J? ^ / r.... tv, V:.,E,R... "2. -z. I . C(;,
Reviewed/Approved: Dept. of Community Services (Date)
S:Permits/formsjILP RESIDENTIAL
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