HomeMy WebLinkAbout06040107 Application
City of Carmel/Clay Township ~ermit #OIo04n I 01
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME
PHONE
07
CITY
~'D~/
FAX
S' ('tl "c 9 ~
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STR>fr ADORES"
V 0 It>c X-
ZIP
BUILDER! EMAIl A~DRESS ~ /'
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BEST METHOD OF CONTAcr:
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PROPERTY
OWNER:
NAME
#Cof)fjU--_/
PHONE
FAX
STREET ADDRESS
CITY
STATE
ZIP
LOCATION
&. PROJECT
INFO:
LOT #
SUBDIVISI9N NAME
t/ t-1" C
, SECTION
N)oO 3
ZONING:
~
SEWER UTILITY
PROVIDER: c'r~WJ::::,
WATER UTILITY
PROVIDER;
SQUARE
FOOTAGE: (0 9 S-1
OF CONSTRUCTlON
/;)/ S-?
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
o i) ~~ J
NAME OF umLITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AN OR SEPTIC PERMIT ,'S (IF APPLICABLE):
o
F IMPROVEMENT:
EW STRUCTURE
OM ADDITION(S)
RCH ADDITION(S)
E ODEL
AC SSORY BUILDING
CHED GARAGE
ATTACHED GARAGE
DEMOLITION
PLUMBING CONTrCTOR:
~ 12. ~ )'0"'/
Plumber's Indiana State License #:
H g.?10/Jo8'o
o
Which plumb' 9 codes will be applied to the construction:
national Residential Code wI Indiana Amendments
Uniform Plumbing Code w/lndiana Amendments
(Multi-Family Construction Code)
~ Manufactured / FOUNDATION TYPE: (Check all that apply for the new
construction area)
Y N Trusses: y' N
- v?,' ---:--. - 0 CRAWLSPACE 0 BQST & BEAM /
Lot Split: Y _N Sump Pump: ~ _N 0 SLAB ~BASEMENT
Does any part ~~~~~ f.Qf.\~OOlilQ\lllsignation area: _ Y ~ WALKOUT:_ Y_N
For Single Family and TWO<ffl~'lgl . gH~i' AcJ..gjfi9{l!,j':~H ~i~r accessory structures, this permit is valid only if construction commences
within 180 day~4a'r\( i~,i1{lfl.j~rtfu.:'i5dittlM~itit, and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Cla~lf!trbcM p~Ll*np ~inistrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
CITY OF CARMEL / ~e,{"IY"1'; j'l\.llndcompletingconstructjon.
I, the undersigned, agree that any constrkl<1\J('P r~mrsl:mcdc , :It'relocanon, or alteration of a structure, or any change in the use of land or
structures requested by this application 1JM!.l~h\pij.Avith, 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 aurhorit 'of I.c. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. 1 further certify that only kitchen, bath, and rains are c ected to the sanitary sewer. I further certify that the construction will not be
used or occupied until a C tjf}cat of Occupan as been issued by t e Department of ;;ommunity Services, Carmel, Indiana.
, l W~. . J,;./("! /0[,
D". I
P
Early Release
Permit:
Upper Footing
Lower Footin
Under Slab
~
Print
I
** *******************~**~******************
i1ing Fees: I 8' '7 (}
I 1 /
Base Inspections: ..2 "1 ~ rJ
OFFICE USE ONLY: ********
INSPECTIONS REQ
P,R,LF,:
# Charged Re-
ReViews
Cert of Occupancy:
J
r
Additional Fees
.
d: Dept. of Community Services (Date)
JDENTIAL