HomeMy WebLinkAbout06030150 Application
-'CityofCarmel/Clay Township V'~.~' Permit#: 0&0301S0 ~.,
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &: Two Family: New Structures, Additions, Remodels, &: Accessory Structures
SEWER UTILITY
PROVIDER:
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STREET ADpRESS :!h ..1 -L>... Lf....&
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FAX
BUILDER of
RECORD:
CITY
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BUILDER'S EMAIl ADDRESS
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PROPERTY
OWNER:
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LOCATION
&: PROJECT
INFO:
LOT #
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
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ESTIMATED COST OF CONSTRUCT!
(EXCLUDING LAND VALUE) \ LPO l OCXJ
Wl\So"-,, W~ J-..~
TYPE OF CONSTRUCTION: TY~ IMPROVEMENT:
-0' SINGLE FAMILY NEW STRUCTURE
o TOWN HOME 0 ROOM ADDITION(S)
o TWO FAMILY 0 PORCH ADDITION(S)
# of units: 0 REMODEL
o MULTI-FAMILY 0 ACCESSORY BUILDING mbing code. will be applied to the construction:
O # of Units: 0 DETACHED GARAGE International Residential Code w/Indiana Amendments
RESIDENTIAL (For 0 ATTACHED GARAGE . . .
Additions, Remodels, Etc.) 0 DEMOLITION 0 Umform Plumbmg Code w/Indlana Amendments
PROJECT INFORMATION: ~~~t~~? ~R.~-Cel\~~
Early Release / Manufactured /' Of S:0'ii6m(':jf.lil1YPltll~_lall that apply for the new
Permit: Y Z Trusses: /= OF C 1t~,I$pdes. \
- @]'..1~liJP)(ciERVI~6ST & BEAM
Lot Split: _ Y N Sump Pump: F CAFliM~ECl^Y Y1:lWNS'H&*SEMENT
Does any part of the property lie within a special Flood designation a>>ilOIAl'4;V ~N WALKOUT:_ Y ,,/ N
PLUMBING CONTRACTOR:
.\\'6C.~-\~+Dv0
Plumber's Indiana State License #:
2? \c>~ S l/O
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences
within 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits are subject to the 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 UZoning Ordinance of Carmel
Indiana - 1993~ (Z~ 289) and amendments, adopted under authority of J.C 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 further certify that the construction will not be
used or occupied until a Certificate Occupancy has been Issued by the Department of CommunIty ServlCes, Carmel, Indiana
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OFFICEUSEONLY:************************************************************************
Filing Fees: }23 l;2. 0
INSPECTIONS REQUIRED: I
~ Base Inspections' ~ h 7 {"O # Charged Re-
~pe~ng ~we~~g _~nder Slab . S/ ~~ Reviews
,::--= ',. Cert. of Occupancy: _ _
~!lh.lit' (Me~ ~ sit;) P.R.LF.: /2 ;; / {)/J Additional Fees
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Reviewed/Approved: Dept. of Community Services (Date) . ,~ :3 SO () It''
S:permitsfForms/llP RESIDENTIAL Fee Rec Ived by: