HomeMy WebLinkAbout06040079 Application
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City of Carmel/Clay Township Permit #~9
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME
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PHONE cfyt - 2762..
FAX? '1(-Y2 2. ((
STREET ADDRESSc:::/" J I L> .
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STATE
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ZIP
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BEST METHOD OF CONTACT:
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PROPERTY
OWNER:
NAME
PHONE
FAX
STREET ADDRESS
CllY
STATE
ZIP
LOCATION
&. PROJECT
INFO:
LOT# '3
SUBDIVISION NAME
'fv.r1 r<JrA /!f
SEWER UTILITY C -r- WATER UTILITY
PROVIOER: J l? W f) PROVIOER: G K ~
NAME OF UTILllY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE{S}; AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TYPE OF IMPROVEMENT:
u--rtfw STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
(.,A '<'K /u
PLUMBING CONTRACTORo:#- 0 GO ~77
Ec<",(' Cr....l1 q,. Ib;. ';$'7
Plumber's Indiana State icense #: .~ 4l )}'<s.
a~ ~
<-oS'
Whic~mbing codes will be applied to the construction: '-. ~
(9""'Jnternational Residential Code wI Indiana Amendmen~"
o Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
TYPE OF CONSTRUCTION:
~NGLE 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: _Y _N
Lot Split: _ Y /../'iJ
Manufactured
Trusses:
t./
Y N
~ 0 CRAWLSPACE
~ Y =N CD--srAB
ignation area: _Y c..-r:J
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Does any part of tl!e.g".'pe
, ,~
For Single Famil~t~yul~Wf Fd~n\W6Ui.R~adlU~' ~ft IfmM"M~r accessory structures, this permit is valid only if construction commences
within 180 days"d'M:~ i:t'atelof WjuanceCfN ~bM1 il}gl?9'.rnlt:-'~;:;d''i~lUSt be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I S[ruct~'pt!~ i\Q AA ~"eral Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
DEPT .oF. CQMMU 'J?(."SlERV,(GEiand completing construction.
I, the undersignep..~ t~~ii.~GtNn, ,e~~l1RplocatlOn, or alteration of a structure, or any change in the use of land or
structures requcs~IUy thi~pIldftMrP~~l , oc! Mnl8'~~~ a" applicable laws of the State of Indiana, and the ~Zoning Ordinance of Carmel
Indiana -1993n (Z~289) and amendmentsJN1lliA r authority of LC. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. 1 further certify that only kitchen, bath, and floor drains are connected to the ~anitary sewer. I further certify that the construction will not be
used o,r occupIed untIl a Certificate of Occupancy has been lssued by the Department of Commumty ServICes, Carmel, Indlana
_ ! L, C-.K<J '-~ L( ~17-(J 6
Prin Date
o POST & BEAM
Gl-1l7\sEMENT ./
WALKOUT:_Y~
OFFICE USE ONLY: **************************************************~*******************
Filing Fees: ~ ~
INSPECTIONS REQUIRED: . /77 --'0
~...-:- _ Base Inspections: cr-- __ J
({lpper Footin~Lower Footing ~Under Slab "-3,. "'---;0
Cert. of Occupancy: v , ;) t
~ghln~ter~ ~ ~ P.R.I.F.: !r2C/ 110
#:7337 30
1l, till uAA;\
1-\ \1- ,\ 19"
# Charged Re-
ReViews
Additional Fees
FeeR~~
Reviewed/Ap roved: Dept. of Community Services
S;PermitsfFormsl PRESIDENTIAL