HomeMy WebLinkAbout06030042 Application
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\ City of Carmel/Clay Township ~permit#~;;;L
\RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
for Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NA'(l .1 , -
STREET A~198
BUILDER'S EMAIL ADDRESS
I f
FAX
LOCAT:J:ON
&. PROJECT
INFO:
BEST METHOD OF CONTACT:
~? --77'7~
PROPERTY
OWNER:
PHONE,'
FAX
STATE
<-I6d8. 9
SECTION
SQUARE AA11
FOOTAGE~I
E5TIMATED:COST'01=XONSfRurnON>.':'~ t .,'-. \'. ::
(EX~~~Df~(t~~D,~lu~Ii~_U \t.EO,!~.G>
':! )' II \ 'Ii
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tl~ u. IiI!' I
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBII!!I'P ",ON " i ~
o SINGLE FAMILY ~ ~EWSTRUCTURE -u LlL ---;//7/./1
00 TOWN HOME ..< I Y. RQ.OM-ADDInQN(S)~ Plumber' Indiana State Licens_e..#": J
TWO FAMILY.,Ll _ ~
# of units: . - _POROtADDITIOI'J(S)
REMODEL
O;} MULTI-FAMILY 0 ACCESSORY BUILDING Which plumbing codes will be applied to the construction:
# of Units: 0 DETACHED GARAGE 0 It- I R -d t- I C d f d- A d
n ematlona eSI en 13 0 e w In lana men ments
....;. RESIDENTIAL (For 0 ATTACHED GARAGE
lif! Additions, Remodels, Etc.) 0 DEMOLITION 0 Uniform Plumbing Code wfIndiana Amendments
i/ (Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release ' .// Manufactured FOUNDATION TYPE: (Check all that apply for the new
~ / construction area)
Permit: _Y _N Trusses: Y /t'N _ - .-/
_Y I 'N-- ./,~ 0' CRAWLSPACE 0 POST & BEAM
Lot Split: v Sump Pump: Y Y =N' 0 SLAB '0 BASEMENT ~
Does any part of the property lie within a special Flood designation area: _ Y 4 WALKOUT:_ Y-LN
For Single Family and Two F1~II;:d~~lfin~, Kda?Bbn~:h:~~a~'srJhd/dr'a~ ~ry structures, this permit is valid only if construction commences
within ISO days of the da&\M.iissua.riee 6fthe;btiiltlmg pi!:rmlt~dilcfi11l9t!lie:t<iOOlpleted (Certificate of Occupancy issued) within IS months of the
issuance date. Class I structure permi,~~a<< ~,~~je<d.!R.lt~;'}$~13b'Mll]jnistrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
i"PT (Ir: f' ,LimY: (r.ll~l\oJ:.f,cgi1Ulip~'Y1~'lu.rp..pleting construction.
I, the undersigned, agree that tOn'st:hicb,otJ.;--tdbiUtAid:ion, ~rlI.ati;1Jn(rltYrl!kf~n, or alteration of a structure, or any change in the use of land or
structures requested by thiGw i arGf\vl!.t~q1'IWi~i:b.,6.r@,19.~mltQijl";'N@:MJpa\VS of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993" (Z- 289) and amendments, adopted \lti~p.Wb,)~ty of I.c. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I fu ther certify tha only I chen, bath, and'fllck{r'BHitts'J.re connected to the sanitary sewer. I further certify that the construction will not be.
used or pie til a C .nib at of anc has een issued by the, Department of Comm~ervice~armel, Indiana.
('~~/;& b__';;,~bc .2,.1 -2-00-6
Print / Date
OFFICE USE ONLY: ***********************************************1"*~********************
Filing Fees: / ~o '7- 0.3
INSPECTIONS REQUIRED: 1/ -- -21U 00
Base Inspections: ~:..- ~ v 7' # Charged Re-
.' ReViews
"I
SEWER UTI
PROVIDER:
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
3 -I'f- ob
ReviewedfAp ved: Dept. of Community Services (Date)
S:PermitsjFormsjILP RESIDENTIAL
dditional Fees
Cert of Occupancy:
Fee Received by: