HomeMy WebLinkAbout06040180 Application
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Permit #:
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City of Carmell Clay Township
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
BUILDER of
RECORD:
NAME
For Single Family, Multi-Family, lIr. Two Family: New Structures, Additions, Remodels, lIr. Accessory Structures
PHONE Y6~:29 'L
FAX c., ( V
dY - 122-
STREET ADDRESr:;:
7 () 2.:;-
ADDRESS OF C9NSTRUCT1p~
<.( 6 ! 51r. <- ~ 1-..5
c;. I'- frt eJ
PROPERTY
OWNER:
NAME
STREET ADDRESS
LOCATION
lIr. PROJECT
INFO:
LOT #
OUt;
SEWER lmLlTY
PROVIDER:
P,
SUBOl ON NAME
,.111'1 J",_u
~r~y
i"'!t: ~~: .~;.",
SQUARE <9/ U/
FOOTAGE:? 7
WATER UTILITY
PROVIDER:
c;,. ,e fJt -< !
ESTIMATED COST OF CONSTRUcnON:
(EXCLUDING LAND VALUE) /~ ()cJ f).'~
NAME OF UTlUTY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); ANDfOR COUN1Y WELL ANDfOR SEPTIC PERMIT #'S (IF APPLICABLE):
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
'"filf) TOWN HOME
/0- TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc,)
TYPE OF IMPROVEMENT:
~EW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
)<A , /cr'
PLUMBING CONTRACTOR: -Q ....~
~- /' q.~,()
cP-( (f he. <./ ~ '%. $...~
Plum er's Indiana State (icense #: .,. ~ ~
/v_)7'tP9 .~ 1-<-.t
Which plumbing codes will be applied to the construction: ." ..,...,>
C91ntemational Residential Code wi Indiana Amendm~
o Uniform Plumbing Code w/lndiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release /' Manufactured FOUNDATION TYPE: (Check all that apply for the new
c.,../" c.......-< construction area)
Permit: Y N Trusses: Y N
. - <.../.: - ~ 0 .}:RAWLSPACE
LotSpht: _Y _N Sump Pump: _Y _N ffSLAB
Does any part of the property lie within a special Flood designation area: _ Y ~
o
o
POST & BEAM
BASEMENT ~
WALKOUT:_Y_N
For Single Family <WJ...l\\W fWl:.dwellings, additions, remodels, and/or accessory structure~, this p,errplLi.-LY.alidJlll!y.ifconstructiol.l commences
within 180 days on~ts:Wam.QmtGe~igRIJlUUst be completed (Cerfif;Lc:-terQtOcpipafiCZ'i~~u9yvfttffirf~~m~mths of the
issuance date. Clas~te)~~J~~~~~ffhTQ:~!ir dministrative Rules of th~!~t~tk df;In31an'a )@eeQZ.5JAC.:12,J:rrgai:dingexpiration
of State GW' L6i~~ III s'1llr'1\\l \ltw.gandcoIllpletingcon4tl15'r!i~ \11 I II
I, the undersigned, 'lSfmfHi~~~IJ5FI(5P" re~dti~ g~:enlargement, relocation, or alteratijl~f!.1~;~~1~ure, or any change in th~.L i~se19~.land or
structures requested"l5'\I IS apPfi'ca~MMIIi@~J~,Sfa~Sall applicable laws of the ~atk.of In~~, anft t~ ~g Ord~nance of Carmel
ldi "(",. 1nC:""""''''''''U ~ al I .lb'fh find LVV all ", '" d
n ana -1993 Z\J,I!j nV'TI~rrrvl PI n ~ . JQ.-7 et seq, Gener Assem IX t e, 0 . ana, an Acts amen atory
thereto. 1 furt~er certi!y that or:Ir ki(che an ddr .. ' Ui:'ed to (he sanitary sew~tJ T. rhtther.cer~if~ that _t~ :~lJti(;ri ~1I not be
used or occupIed until a Certifi.cate of s been Issued by the Department of Comrrumty SemE'es, Carmel, IndIana. !
::2 !~ (- ?= if 0 C(;: _ -------v--=.2h -g 1>
Sig Print Date
OFFICEUSEONLY:*****************************************************~******************
Filing Fees: (;() .3 _/0
INSPECTIONS REQUIRED:
_ ~ Base Inspections: ~;2 / (J # Charged Reo.
/Upper Footin:J Lower Footin _ ~ Reviews
'----.:: - Cert. of Occupancy: ,Z;- 3, <;()
~ Site P.R.I.F.: / -:( /,/.. 00 Additional Fees
TOTAL: 1 v ~ 01/7'-.5'./0
Reviewed/Appro ed: Dept. of Community Services
S:PermitsjFonnS/llP RESIDENTIAL
Fee Received by: