HomeMy WebLinkAbout06050025 Application
City of Carmel/Clay Township Permit #()fn05D()j'3
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
Manufactured FOUNDATION TYP
_Y Vc N construction area)
Trusses: ,......
J 0 CRAWLSPACE
Lot Split: _ Y ~N Sump Pump: .J>..,.- Y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _Y LN
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is vali
within 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy is
issuance date. Class I structure permits arc subject to the General Administrative Rules of the State of Indiana (See 675
time frames for beginning and completing construction.
I, the undersigned, agree that-any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or
structures requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the ~Zoning Ordinance of Carmel
Indiana -I993n (2- 289) an mendments, adopted under authority of I.C. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. 1 further certify t t nly kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
used upied until a e ei{jcate of Occupancy has been issued by the Department of Community Services, Carmd, Indiana.
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Print
OFFICE USE ONLY: ************************************************************************
SPECTIONS REQUIRED: RELEASED t~ C'O~STRUCTI~ I, l3 ~, 7 (J
__ to cOrnl3aaedesp~m:illnffigulatl '3 '5 06
ab 0 ~ tator")rif br'O'c!c\1SglT&: c$ 5" 3,5 6
. CO~~NlUNITY SERVICE"
',\[1/iF/fFkI,F,Gl:AY TO":VNSI~fl ;Z (p (. 00
, 'INO!A,NP..t;; TAL: . 3 a
BUILDER of
RECORD:
NAME
c> II<. OAvl) ~o
STREET ADDRESS
7-0-1.>
BUILDER'S EMAIl ADDRESS
j)#m~
7P'1A>L
PROPERTY
OWNER:
NAME
51c-N, C
5 I'h-L:::-
STREET ADDRESS
LOCATION
&. PROJECT
INFO:
LOT #
SEWER UTILI1J ,
PROVIDER: l!.LII
WATER UTILITY
PROVIDER: .~
PLAN COMMISSION / BZA / BPW DOCKET
AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
NAME OF LfTILITY EXCAVATION C
NUMBERS; TAC DATE(S); AND
o
F IMPROVEMENT:
NEW STRUCTURE
OOM ADDITION(S)
ORCH ADDITlON(S)
REMODEL
ACCESSORY BUILDING
DETACHED GARAGE
ATTACHED GARAGE
DEMOLITION
PR ECT I
Early Release
Permit:
_y:L..N
Si
"-
,
PHONE
lf~o}.~1
FAX
a
CITY
STATE
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,
,
,
BEST METHOD OF CONTACT:
I
PHONE
FAX
~-
CITY
STATE
ZIP
SECTlON
ZONINGS -c.
SQUARE a
FOOTAGE: 18177
ESTIMATED COST OF CONSTRUCTION: .tY2-
(EXCLUDING LAND VALUE) 800 ()(J() f
PLUMBING CONTRACTOR:
l-!-m.t N ~ 5o,.;l5 pc. ? lib 00/0 / .
Plumber's indiana State License #:
Which plumbing codes will be applied to the construction:
a;2 International Residential Code w IIndi
o Uniform Plumbing Code w lana Amendmen~
(Multi-Family Construction de) - ~
(Check all that apply for the new
Yi-N
if construction commences
. hin 18 months of the
ation
A\ VII-v;>
~-'I~6.
Date
# Charged Re-
RevIews
Additional Fees
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