HomeMy WebLinkAbout06040039 Application
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City of Carmel/Clay Township Permit #Ob7,()()<./ I
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME
PROPERTY
OWNER:
NAME
STREET ADDRESS
LOCATION
&. PROJECT
INFO:
LOT #
SEWER UTILITY fl. -/} i . 1D
PROVIDER: vi ~.A!V
FAX ~j(tr!/J-d(
tf& ~ C/t
~
ZIP
c/
ZONING:
va
SQUARE ;1. ~ 19
OOTAGE: .
ESTIMATEO COST OF CONSTRUCTION: 13 C\/ rr./'I
(EXCLUDING LAND VALUE) U LLCJ
Itl S DC *!rx:ofo03"
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
TYPE OF CONSTRUCTION:
A SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI.FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit:
yXN
yX"N'
Lot Split:
Does any part of the ro e
,
TYPE OF IMPROVEMENT:
%NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
PLUMBING CONTRACTOR:
EdiJej h~q:f
Plumber's Indiana State Lice se #:
!Ors-qiJt:J
~iC~IUmbing codes will be "Plied to the construction:
~nternational Residential Code w/lndiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE:
Manufactured \/ construction area)
Trusses: 4- Y N
V P CRAWLSPACE
Sump Pump: _ Y 4-N ~ SLAB
lie within a special Flood designation area: _y.x N
(Check all that apply for the new
o POST & BEAM
o BASEMENT
WALKOUT:_Y_N
For Single Family andl1}w,gcmYdb'ffiumg~A~diH!eel~'.i~n or accessory structures, this permit is valid only if construction commences
within 180 days of tiJ'e Cl:h.le hr~l}~nce!"m'iTl~"bttiral i ,Wi completed (Certificate of Occupancy issued) within 18 months of the
issuance clate. Class I structure Tlh~tf~t.ReC!GGje~ asl Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
DEPT OF COMMitjNt~SZIees:tcomplet;ngconstruction.
I, the undersigned, ~'r'ittc~,?pe!Nfe(eci'l}iol;iU~qqn IPf8tJ_!jl~ation, or alteration of a structure, or any change in the use of land or
structures rcquested'1'5'1 tbi~ aPlSficabHi'i'WID"b~miplf ~~ c fN,~l5ficable laws of the State of Indiana, and the ~Zoning Ordinance of Carmel
Indiana - 199r (Z~ 289) and amendments, a~A-NAuthoriry of LC. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify t t only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
used or cupied until a ni!icate Occupancy has been Issued by the Department of CommunIty ServIces, Carmel, IndIana.
, \(D(\ ir~ (~y(((
Print ~ Date
NLY: ***********************************************~*~~*******************
INSPECTIONS REQUIRED: Filing Fees: i' /7--:-1(1
c ~ Base Inspections: ~ :;21 :) (J
~p..r r"ot;::;Y' Lower Footing CU...R.. ...Id~~ ~' /;\
- - _" Cert. of Occupancy: $ -:; "5 u
CROUghJD-~r Basy'Final Site --', .
-....:..:::: ____ P.R.I.F.:
# Charged Re-
Reviews
Additional Fees
.
Cv~l g I1J$.D..r <f-It-06
Reviewed/Appro ed: Dept. of Community Services (Date)
S;PermitsfFormslILP RESIDENTIAL