HomeMy WebLinkAbout06030185 Application
City of Carmel/Clay Township Permit #:Ot,()30 /8')-
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
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FAX
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BUILDER of
RECORD:
NAME
CITY
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STATE
ZIP
STREET ADDRESS
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BEST METHOD OF CONTACT:
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BUILDER'S EMMl ADDRESS
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PHONE
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CITY
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FAX
PROPERTY
OWNER:
NAME
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STREET ADDRESS
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STATE
ZIP
.;)dLj.
LOT #
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LOCATION
& PROJECT
INFO:
SECTION
ZONING:
SEWER LfTILITY 0
PROVIDER: -f1.1'; I'<~€--
SQUARE
FOOTAGE:
ADDRESS OF CONSTRUCTION -+/-l .........1
J.f 0 } 3 (." C:::t'lLL&.:
Plumber's India
ESTIMATED COST OF CONSTRUCTlON:
(EXCLUDING LAND VALUE)
WATER umLITY
PROVIDER: ~E-
NAME OF UTlUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
CON RUCTI N: TYPE OF IMPROVEMENT:
SINGLE FAMILY 0 NEW STRUCTURE
o TOWN HOME 0 ROOM ADDITION(S)
o TWO FAMILY 0
# of units: 0 PORCH ADDITION(S)
REMODEL
o MULTI-FAMILY 0 ACCESSORY BUILDING
# of Units: 0 DETACHED GARAGE 0
o RESIDENTIAL (For 0 ATTACHED GARAGE 0
AddIWA'i. Remodels. Etc.) ~ DEMOLITION Uniform Plumbing Code wI Indiana Amendments
Ht::LEASFn f=t"\R C (Multi-Family Construction Code)
PROJE~6Hl~JJ:~~r,:nGe c;,1Ih oTRUCT/ON
Early Release of State a~d lc J~lwtif~Ci1a\lelions FOUNDATION TYPE: (Check all that apply for the new
Permit: DEPT QF...CA N 'c:H.I~si;. Y N construction area)
1.\1 6t;>ffijd;i\!ITY S;:::':jl/ICES - 0 CRAWLSPACE
Lot S.....:TY OF -CAJtl~ / cc~1?I}P~h'lP, - Y _N 0 SLAB
Does any part of the P'1I\IEJY< ' Withi~~~e1tIl~loOd designation area: _Y_N
PLUMBING
o POST & BEAM
~BASEMENT
WALKOUT:_Y_N
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 "Zoning Ordinance of Carmel
Indiana - 1993" (Z~ 289) and amendments, adopted under authority of r.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I fun eItify that 'kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
used or aceu d ntH a e ncace of Occupancy has been issued by t~~(~~:~ervices, Carmel, Indiana. Db'! / tJ C,
orized Agent Print Datel 7
Upper Footing Lower Footing Under Slab
Rough In Meter Base5'7r~a~~
# Charged Re-
ReViews
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Revie ed/Approved: Dept. of Community Services (Date)
S:Permi /FormS/ILP RESIDENTIAL
Additional Fees