HomeMy WebLinkAbout06040002 Application
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City of Carmel/Clay Township ~" Permit #:Ob/JlfIJo/?:)"
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
NAME
LL -1-0
PHONE
WtlLi.- t;:;ns-kvc//od L.LC.
FAX
)/ 7~Y's 7-:Z07 3/ ;;-?t..s--/fI/o
STREET ADDRESS
CITY
k/I>VS ToN 71u,"- ~xJO':<:-5
STATE
::{)t/.
ZIP
Y',c.2 ~ 0
BEST METHOD OF CONTACT:
3/7-</.F7-?(09
PROPERTY
OWNER:
NAME
d{ f- ft 111
j2e"il-#f- SO'le 5
PHONE
~/7-S(,/-/~J
FAX
STREET ADDRESS
/3'/00 bf'0lt5e
101'1/-r ~/L-
CITY
Cnol1e '-
STATE
IV
ZIP
LOCATION
& PROJECT
INFO:
LOT #
IS-
SUBDIVISION NAME
(l
SECTION
ZONING:
fb ,,1/ +-
~ #1 L-
SQUARE S LJ() .sf:
FOOTAGE: .-/ 7C :rF
SEWER UTILITY
PROVIDER:
ESTIMATED COST OF CONSTRUCTION:
LAr~ -e c (EXCLUDING LAND VALUE) ;< '7-: 000, 00
,
SlON / BZA I BPW DOCKET N A
. . C PERMIT #'5 (IF APPLICABLE): .-
o
F ON
SINGLE
TOWN H
TWO FA
# ofuni
MULTI-FA
# of Units:
RESIDENTIA
Additions, Re
PLUMBING CONTRACTOR:
Jj-A
Which plumbing codes will be applied to the construction:
rd
PROJECT INFORMATION:
Early Release /
Permit: y v' N
=y~
POST & BEAM
BASEMENT
WALKOur:_Y_N
For Single Family and Two Family dwellings, additions, remo . and/or accessory structures, this permit i~ 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 arc 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 applicat. ion will com PI.' . h ~Inform to, all applicable l.aws of the State of Indiana, and the ~Zoning Ordinance of Carmd
Indiana - 1993" (Z' 289) and amendments, adopted .. ilmiJI... .. ' . IfssemblY of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen, bath, an' , " . ,'c d . 'r. I further certify that the construction will not be
used or accu ied until a Certificate of Occupanc een 156 y_ C!. nity Services, Carmel, Indiana.
. c...K.../l/il1..I f)"'!JP'::' 0-3-o~
Sign ure of Owner or Authorized Agent Print Date
OFFICEUSEONLY:************************************************************************
~ Filing Fees: / ~~ ':3 0
ECTIONS REQUIRED: /.~ .
./ Base Inspections: . - ;;L 00 # Charged Re.
Upper Footing Lower Footing .J _...- ReViews
_ _' Cert. of Occupancy: S "5. '5 0
Rough In Meter Base AddT I
J P'R'~I.F': Ilona Fees
\ J ~ ~~~-4~~9IAL: ~70/1 go
'I) oved: Dept. of Community Services (Date) ~_~~ p"C:;;Z?/--{
_IILP RESIDENTIAL F eceived by:
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