HomeMy WebLinkAbout06030005 Application
~~-City of Carmel/Clay Township Permit #: 0(; OJ ffD05
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
PHONE
FAX
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STATE
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PROPERTY
OWNER:
FAX
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STATE ZIP ~ I
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LOCATION
&. PROJECT
INFO:
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SUBDMSION NA~ r-,
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SECTION
ZONING: 5- /
ADDRESS OF C9~UCTION
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~~:O~UTY /t},'7J ~:O~I~~UTY (?~/
NAME OF UTlUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
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SQUARE
FOOTAGE:
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ESTIMATED COST OF CONSTRUCTION: -._-.... -
(EXCLUDING LAND Y~,LU\E~ ! ( ..: c-<;:- ~'fl \':
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TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDmON(S)
o PORCH ADDmON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
S ATTACHED GARAGE
lP' DEMOUTION
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PLUMBING CONTRAc:J'OR:
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TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
o R~~6~~h
AdditiOnS,~ c.)
to ;:-'0
PROlE . 'IT
~ O' t,te'/)/Q!)~ ~~I \ FOUNDATION TYPE: (Checkallthatapplyforthenew
Early .Re ~f:" 'f:'" "'I'?, fCI) '%,";;'~fJ.ured construction area)
Permit: -GtzYQ!2N ,,~Trii~f,' Uo Y N
Lot Split: _~.Jt1;~~~ii~~Ot\1 Y \~ ~ g ~~:LSPACE ~---~~~M&E~~M i ..
/1\' 9'f.f:~ y ("-., s. Iq/)A Y:' ~ __~~
Does any part ofthe ~A'~~i~yM:1WJr speclarFlood ~esignation area: _Y ~/ WALKOUT:=--Y~N
For Single Family and"Two FanillY'dwellin~WW,n remodels, and/or accessory structures, this permit is valid only if construction commences
within 180 days of the date of issuance of the-bK~:nennit. and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits are subject t'o'lfii General Administrative Rules of the State of Indiana (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 Carmel
Indiana -1993" (Z,289) and amendments, adopted under authority of LC. 36'7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I funher certify that the construction will not be
us or occupied un . a Certificate of Occupancy has been issued by the ~epanment of Community Services, Carmel. Indiana. /
USA. ~')\~ ~_//{)7
I ture of Owner or Authorized Agent Print Date . I
Plumber's Indiana ~tate License #:
Which plumbing codes will be applied to the construction:
o International Residential Code w!Indiana Amendments
o Unifonn Plumbing Code w!Indiana Amendments
(Multi-Family Construction Code)
OFFICE USE ONLY: *** ***** ****** ********* ***** ************* *** ******-**s* **** * ** * ~* **** **
Filing Fees: 'i/fi.> - ::J/J 0 ? J
INSPECTIONS REQUIRED: I _ '.?< 0 .
Base Inspections: ,c, 3. '5 () # Charged Re-
Upper Footing Lower Footing ReViews
Rough In
Meter Base
Final
Cert. of Occupancy:
P.R.I.~.: ' Additional Fees
I /) 0/ ~
. ,. TOT~L;: 1/ ]:/ / cP e;Y-- .. 02)
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Fee Received by:
Reviewed! Ap roved: Dept. of Community Services
RESIDENTIAL