HomeMy WebLinkAbout060300117 Application
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City of Carmel/Clay Township Permit #/J6/J:gOI/CJ
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of NAME PHONE 2 ))--71tJO FAX
T 2o..}--9"'I'11J
RECORD:
STREET A RESS CITY J;. ZIP
,I.ft.: CAd{f,;' i b 2- 1/ 0
BUILDER'S EMAIL ADDRESS B~OD OF COI'ITACT:
Co ..,;:- -.7
I --~"
PROPERTY NAME i: FAX
OWNER:
STREET ADDRESS ZIP
TY~ IMPROVEMENT:
NEW STRUCTURE
o ROOM ADDmON(S)
o PORCH ADDmON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
LOCATION
&. PROJECT
INFO:
LOT# n
SUBDMSION NAME / / / / L..
rr<~ (/(...{..../t (j
NAME OF UTIlITY EXCAVATION COI'ITRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
Jzz-
: 2J!, 0110. vO
Ivl '#"0603011 ~
III DC ~-l--
q,.~' ..0
-plhl f 5;.. / fA ,~:!;.
PI ber's India~a State License #: .' ~~.,
It) I 77) ~~~,'-,
Which ~mbing codes will be applied to the construction: ~rJ!~ i'
rn-1iitemational Residential Code w/Indiana AmendmenbiP
o Unifonn Plumbing Code w/Indiana Amendments
(MUlti-Family Construction Code)
PROJECT INFORMATION: i,
/' Manufactured / FOUN~N TYPE: (Check all that apply for the new
Early Release V., Vy N co~' ,rea)~
Permit: _Y _~ Trusses: ~ ' ..,
..:./.. /" WLSPACE !~"'+J ~ & BEAM
Lot Split: _Y _N Sump Pump: ~ =N "~VW o/,'};;_~'r)/j/,:,: err~~EMENT
Does any part of the property lie within a special Flood deSignatio,{:'ai'E)a:', "'V, ':~~ '::'-' ',:",wALl<EWT_ Y ~
For Single Family and Two Family dwellings, additions, remodels, and/or accessory struc~;es~:thi~ p~fniiqs Xilid'o~ly'~ c'(~~ffu6lGtaaommences
within 180 days of the date of issuance of the building permit, and must be completed (Certificate!of9,ccuI)an6Y/is,su,~d),~tJilrl!~W~ths of the
issuance date. Class I structure permits are subject to the General Administrative Rules of the State}]f 1ll:'dblnA(S~t; 675 ,IA,C; '12) regaromg expiration
time frames for beginning and completing construction~ 0/~/ ' '" '; .~. >,~ I -I ~~I ^
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a strUctur~4 any charig~, in..tn~ o~ land or
structures requested by this application will comply with. and conform to, all applicable laws of the State of Indiana, and the "Zonili~~ce of Cannel
Indiana -1993" (Z~289) and amendments, adopted under authority of LC 36~7 et seq, General Assembly of the State of Indiana, and all A~lttmendatory
thereto. 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
used or oc upied until a Certilicate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
. ~ i-. Cre Oct:: -c:1.CjeAr- 7-/6-C/6
Si nature of Owner or Authorized Agent Prh1t ;' Date
ADDRESS OF C~STRUCTlON
~6 FJ ~VJ"I<
WATER UTIlITY /.
PROVIDER: l.<'<- <. 1"<0<-
SEWER UTIlITY
PROVIDER:
Cp. IN~
TYPE qE CONSTRUCTION:
if SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
OFFICE USE ONLY: ***************************************** ****~~*************************
Filing Fees: X() '7, ~ 0
INSPECTlONS RE. QUIRED: ::; / 7 <~O # Charged Re-
~_ Base Inspections: c:2:S !:] ---' .
~er I'oo~wer Foot~ Under Slab J "'--0 ReViews
_ _ - _ Cert, of Occupancy: ,,/, )
Rou In eter Bas Final Si / c2 h I, /if)
P,R,LF.: _~ u
,
(;2 3 ~
Additional Fees
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