HomeMy WebLinkAbout06030066 Application
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City of Carmel/Clay Township Permit # {LJ~OlJb~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of NAME PHONE FAX
RECORD: c. L.A- 873- C'2../9
STREET ADDRESS OTY STATE ZIP
:; OJ C?~ I,J 03'l..,
BUILDER'S EMAIL ADDRESS BEST METHOD OF CONTACT:
STREET AOORESS
35b
C~L .
PHONE
73--QCj:z..9
PROPERTY
OWNER:
NAME
CL SSIC. I+r>>'VJCS I
FAX
..t 19).2..(,1 - 37 ~L
Q c Lt;-
CITY
Q~€L
STATE
JJ
ZIP
<>3~
LOCATION
&. PROJECT
INFO:
LQT#
SUBDMSION NAME
SECTION
ZONING:
5/
ADDRESS OF CONsrRUcrrON
/ :3 LA~&.
SQUARE
FOOTAGE: 7t
t:It>
SEWER UTILITY
PROVIDER: CLPl' Twf
WATER UTILITY
PROVIDER:
EL
ESTIMATED COST OF CONSfRUcnON:
(EXCLUDING LANO VALUE) 1J. 4-~s 00(1
o 0300(;.3
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE): e 161<... ~7<-C<<" q-n h!
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR: A
~ SINGLE FAMILY 1M NEW STRUCTURE _.,f e-
O TOWN HOME /0 ROOM ADDmON(S) Plumber's Indiana State li
o TWO FAMILY 0 PORCH ADDmON(S)
# of units: 0 REMODEL
o MULTI-FAMILY 0 ACCESSORY BUILDING
# of Units: 0 DETACHED GARAGE
o RESIDENTIAL (For 0 ATTACHED GARAGE
Additions, Remodels, Etc.) 0 DEMOLmON
PROJECT INFORMATION:
Early Release / Manufactured /
Permit: Y ~J11 Trusses: _Y ~N
V N / 0 CRAWLSPACE
Lot Split: _Y _N Sump Pump: -M-Y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _Y VN
FOUNDATION TYPE: (Check all that apply for
construction area)
o yoST & BEAM
~ BASEMENT /'
WALKOUT:~Y_N
For Single Family and T\ft~~A~~,aQdJ~ E'1Ul9dels, and/or accessory structures, this permit is valid only if construction commences
'Within 180 days of theEl,~ or'r~~a'ot th~ndillMJ~!RtJ@Wferfmpleted (Certificate of Occupancy issued) 'Within 18 months of the
issuance date. Class I stt'ilM\i/lip~rlllitl1\l/l1~C9' WltIf"tl2AsWJill!j;ttative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
of Slate l'i/ffl f['I'/}l'.1ifqr..~ nMI11fi\\9Q3mpleting construction.
I, the undersigned, agree ~oeJru~Ifi1f>'p;>~c';tJih~ ~ent, relocation, or alteration of a structure, or any change in the use of land or
structures requested by ,dii'r"Pp!\l::i1lion )Vjll'Cof1Il\lyv+.li8lWrtl~~able laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993" (Z. 289) 'lllid'arlu:~e.GAaqrutl!it.n~ . . ;fll. General Assembly of the State of Indiana. and all Acts amendatory
thereto. I further certify that only kitchen, barn. ~qp ains ar ille sanitary sewer. I further certify that the construction will not be
used or occupied until a Certificate of OccupUn'i-yHli issued by the Department of Community Services, Carmel, Indiana.
~ .- R.. J? P. p....JcJ 3;'0 /0/:,.-------... 1(...1 P
Signature ~er'or Authorized Agent ~./ Print
/
OFFICE USE ONLY: ****************';t********* **********************'9'****-****************
I [3/ Fif' gFees: //.3.5, dO
INSPECTIONS REQUIRED: I ~ _ " .
J'LI se Inspections: 3;Z;. Or) # Charged Re-
pper Footing ower Footing Under Slab -' ~I "--0 Reviews
Cert. of Occupancy: 0 . "
P,R,I.F.: /d t, I 00 Addillonal Fees
~g60
Fee Received by:
;J./ID /0 f-
Date
Meter Base
c:: V"a..) C} f1/~CZA.r- 5-1 '3 -~
Reviewed/Approved: Dept. of Community Services (Date)
S:PermIts/Forms/ILP RESIDENTIAL