HomeMy WebLinkAbout06050033 Application
City of Carmel/Clay Township U^- Permit #Oh05tJ03g
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME
CK DU/~""
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PHONE
~9~-S-lffl.-
FAX
~'17-zg-u
PROPERTY
OWNER:
13 W
cm
1'ClI-I <;;..,
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STATE
1,,-,
ZIP
STREET ADDRESS
C?go'l
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(/11
BEST METHOD OF CONTACT:
0'1- /2- 70
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FAX
SUBDIVISION NAME /'! .
t-ool
CITY
Ckt-17t6t-
. r ..1-L SECTION
Non Y/ .
STATE
IA.<
ZIP
l/f,O]'Z.
STREET ADDRESS
LOCATION
&. PROJECT
INFO:
-'
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ADDRESS OF CONSTRUCTION
'3 L{ .>
-
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h?L
SQUARE '7 I/)r' ,./
FOOTAGE: ) 7 ........
SEWER UTILITY ~ WATER UTILITY E MATED COST OF CONSTRUCTION:
PROVIDER, /I /PROVIDER, (EXCLUDING LANO-VALUEj---,-.J:!;l--'''-'''--'
\.....t.lr--m I r ~, f"r"" f."'~;" :.jJ ~ '''0 V-;::) i _ \ ~
NAME OF UTlLm EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET 'I:, II' IL)1 \ .L',""_'~,e'.'~,'" ~_V! 1-"'::.:11 II" \\\\ II
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING co~iT, CT y - 2006 I! Iii
o SINGLE FAMILY 0 NEW STRUCTURE 00 E:- U I kOIES) nc. !JJ
o TOWN HOME 0 ROOM ADDITION(S) Plumber's India~a StateliCe,nse #: ~ J'
o TWO FAMILY LL- "'"'/
# of units: 8-- ~~~~~~~DITION(S) r~V /q~ 00 Lf I '.~
o MULTI -FAMILY 0 ACCESSORY BUILDING Which plumbing codes will be applied to the construction:
# of Units: ~ ./
0' RESIDENTIAL (For 0 DETACHED GARAGE L!1'Intemational Residential Code w/lndiana Amendments
o ATTACHED GARAGE
Additions, Remodels, Etc,) 0 DEMOLITION 0 Uniform Plumbing Code w/lndiana Amendments
(Multi'Family Construction Code)
PROJECT INFORMATION: ~'
Early Release ~ Manufactured FOUND~TION TYPE: (Check all that apply for the new
P't Y N T Y N construction area)
erml: ~. russes:.'
. - - - --;-" ~ 0 CRAWLSPACE 0 POST & BEAM
Lot Split: _ Y _ Sump Pump: _ Y _'-if 0 SLAB p_ BASEMENT _'
Does any part of the property lie within a special Flood designation area: _ Y ~ WALKOUT:_ Y_~
For Single Family a~a~ff~.oo.NSsT~TslQ!\tor accessory structures, this permit is valid only if construction commences
. within 180 days of ~SB~tPttfWPfiD~~WcBWftW~B~~~t be completed (Certificate of Occupancy issued) within 18 months ofthe
Issuance date. Class ~~rut'EurC#efflYlsfare~bJectJiP !$i fycntfXdministrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
o a e an t1Rt~rHa 'it, '~efiiAn,Ln~ and completing construction.
I, the undersigned, agt}lffiffi:~nWQM:fV\t.lW~~dD:Etl\N~~, relocation, or alteration of a structure, or any change in the use of land or
structures requestedPfI~i}o~fl'i~ij pl~tA.~~km1~~plicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993" (Z~2~:lng a~lIidlrlGtR';td tJ. u'idef'autHofi'ty 'bt rt:'3~~~ et scq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. 1 further certify that 0 y . chen ~M:Ar drains are connected to the sanitary sewer. I further certify that the construction will not be
used u d til a G Tt 'fj toe pancyhas7ued by the Department of Communit Services, Carmel, Indiana.
- IrlI'f. l.-JC-r ~ pc ~
Print
Df~~0
OFFICEUSEONLY:********************************************~~*************************
Filing Fees: / =' :3. StJ
INSPECTIONS REQUIRED: '1/'/' CU' h
Base Inspections: _ _' # C arged Re.
Upper Footing Lower Footing Under Slab _ /) Reviews
Cert, of Occupancy: ~ 3, :::> u
(Ro~:S;V Meter Base f~a0 Site
P.R,LF.: Additional Fees
, TOTAL: / ;;29?'. (}O .
Reviewed/Appr ved, ept. of Community Services ~ O. ').( ~r) 5//0)Db
S:Permits/Forms/llP RESIDENTIAL Fee Received b '