HomeMy WebLinkAbout06040052 Application
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City afCarmel/Clay Township O*', Permit #:~4WF);;L
RESIDENTIAL IMPROVEMENT LOCATION PEnflT APPLICATION
For Single Family, Multi-Family, a Two Family: New Structures, Additions, Remodels, a Accessory Structures
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NAME
BUILDER of
RECORD:
PROPERTY
OWNER:
NAME
STREET ADDRESS
LOCATION
lit PROJECT
INFO:
LOT#7t:.
SUBDMSION NAME / / LI
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SEWER UTIUTY C"
PROVIDER:
ADDRESS OF CONSTRUCTION
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ROVEMENT:
UCTURE
ROO ADDmON(S)
P CH ADDmON(S)
EMODEL
ACCESSORY BUILDING
DETACHED GARAGE
ATTACHED GARAGE
DEMOLmON
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ZIP
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PHONE
FAX
OTY
ZIP
STATE
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SECTION
ZONING:
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SQUARE
FOOTAGE:
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Early Release . / Manufactured./ FOUND~TIONTYPE: (Check all that apply for the new
Permit: _Y -.:::::N Trusses: 0. N cons~ction area)
, '" ~-1zj' c;.RAWLSPACE 0 fiST & BEAM
Lot Split: _Y L-N Sump Pump: _Y _N CO/SLAB g' BASEMENT
Does any p;li!fortlie:Pi:i:iPeA:YJlie wltliiiBITfIlel@ll@H designation area: _Y ~ WALKOLrr:_Y ~
For Single a:Dill~:tid fiva~yJrilliVcf$elliX~J.rld1Ii o. iR~~andJor accessory structures, this permit is valid only if construction commences
within 180 qays of th2dati.-:tot~llfJelof1ili~h::'~nnit. and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance dateOOa;srrst!U:ctttEefE~~Jt!C~dministratiVe Rules of the State of Indiana (See 675 lAC 12) regarding expiration
~ITv;~ t:AI=l~r.>=1 I"" \il{lF 'ngandcompletingconstruction.
I, the undeMgrted., a'gRe that <11l"d:h'rstrutn~lhts , ent, relocation, or alteration of a structure, or any change in the use of land or
structures requested by this applicaJ:NetA~ly 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 I.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 Certifica.te of Occupancy has been issued by t epartment of Community Services, Carmel, Indiana.
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SI re of Owner or Authoriz Pri t Date
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Filing Fees: 4~ . '7()
INSPECTIONS REQUI . ,,---0
Base Inspections: r--2 71. 2> # Charged Re-
ReViews
Cert. of Occupancy: .<> 3.<;" iJ
P.R.I.F.: /.;2 C I {) rJ
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Fee Received by:
Site
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Reviewed/ Ap roved: Dept of Community Services
S:PermIts/Forms/IlP RESIDENTIAL
Additional Fees