HomeMy WebLinkAbout06040142 Application
City of Carmel/Clay Township ~ Permit #: ,I) & 0 ~ 6 11-1- d-
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
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PHONE FAX
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CITY STATE ZIP
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BEST METHOD OF CONTAcr:
PHONE FAX
CITY STATE ZIP
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SEmON ZONING:
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BUILDER of
RECORD:
NAME
PROPERTY
OWNER:
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BUILDER'S EMAIL ADDRESS
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NAME
STREET ADDRESS
LOCATION
&. PROJECT
INFO:
lOT # 'C'''.'
SUBDIVISION NAME
ADDRESS OF CONSTRUcrrON
SQUARE 8+"1.0*
FOOTAGE: .
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SEWER UTIlITY WATER UTIiITY ESTIMATED COST OF c;cINSTRucnON:'
PROVIDER: Q~ PROVID,E~:\ \ ..~ 0 (EXClUDING LAND VA~YP ! '~F::; (C';
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I'W I BPW DOCKET j,l U <
NUMBERS; TAC DATE(S); ANa/OR COUNTY WEll AND/OR SEPTIc'PE #'S (IF APPUCABLE): I! n I
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TYPE OF CONSTRUC!16~/ TYPE(fIM \ VE PLUMBING CONTRAcFOR: 200
~ SINGLE FAMh;Y~,~~:\ 0""- 'l.~ NEW-S:fRU RE 9.~. M......r...! ......--
o TOWN HOME \ ,'; .' L'\ '\> Q/ROOM_' mON(S) Plumber's Indiana State License #:
o TWOFAMILY ~\'\ 0 -
# of unl'ts., \\\'\'<\ / "9RCH ADDmON(S) .... .....'"
~,..\;i\, D/REMODEL Q 0
o MULTI-FAMILY ,\1 ,e:l ACCESSORY BUILDING Which plumbing codes will be applied'" the construction: I
# of Units: \ / 0 DETACHED GARAGE ~ International Residential Code w/Indiana Amendments
o RESIDENTIAL (For \ ,/ 0 ATTACHED GARAGE
Additions, Remodels, Etc.) 0 DEMOLmON 0 Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
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PROJECT INFORMATION:
Early Release
Permit:
o CRAWLSPACE
Lot Split: _Y ~N Sump Pump: .:!""Y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _Y ~N
_Y~N
Manufactured
Trusses:
~Y_N
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o POST & BEAM
~ BASEMENT
WALKOLrr:_Y~N
For Single F~~~~l'i'rmitibtG;tclQlhlls, and/or accessory structures, this permit is valid only if construction commences
within 180 ~f.Rl:ffil1saec~f,~~~p!.~ ~1J11~a.p~~@ld must be completed (Certificate of Occupancy issued) within 18 months of the
issuance d~te.""'C1ass I stm~~r~ P~~~~t~~~~8b~s~e General.Ad~strative Ru~es of the Stat~ of Indiana (See 675 lAC 12) regarding expiration
a . time fiafues fqr~mng and completmg construction.
It the undersig&&:. ~aa& G:D.f-'constMdtidilJre~dhJ[rtlt't{J'~ement, relocation, or alteration of a structure, or any change in the use of land or
structures re1j1:\lJSfC5llmWi~-awm.~Jl wjU.cqm.E~ ~t1~;'ffls5f'tW'to, all apphcable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana -199yt:!>2891!mcHiribldR.,,~~IJ~~~ed unaer authonty of'I.c. 36,7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only klti3l1et1/Mblf,-\md floor drains are connected to the sanitary sewer. I further certify that the construction will not be
use 0 occupied u . a Certi1icate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
Ad~'"
Print
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l'.-ct- /I)",
Date
'FFICEUSEONLY:************************************************~**~~*******************
\ Filing Fees: / r;2 G (J' .. U U
\ SPECTIONS REQUIRED: { <'
\. ' Base Inspections: r;J 7 7 .J d # Charged Re-
'oer Footing _ ReViews
, , r;;;:;= Cert. of Occupancy: ,:> ..3 . <ifJ
~~ete.:B~ ~l- ~ P.R.LF.: / --y t /. nO Additional Fees
\ / '^- ~ '6 G (), 00
M\""'E./2.. 4-2-'-00 4. tP(o
" Dept. of Community Services (Date)
-:.IDENTIAl