HomeMy WebLinkAbout06050052 Application
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City ofCarmellClay Township Permit #: 0(,0';- tJl1t{J.-
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
FAX
?..J3
STATE
%IO~ll
BEST METHOD OF CONTACT:
PROPERTY
OWNER:
FAX
LOCATION
&. PROJECT
INFO:
SEmON
, ZIP
1{-(o01:i2.
ZONING(p lI\. 0
SQUARE
FOOTAGE: .
SEWER UTlLITY/)/}
PROVIDER: ~
<~
WATER UTILITY
PROVIDER: C~
ESTIMATED COST OF CONSTRUCTION:.
(EXCLUDING lAND VALUE) q 5 0' rn
NAME OF lJT1U1Y EX ' ATION CONTRACTOR; PLAN COMMISSION / BZA / W DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
'\
TYPE OF IMPROVEMENT:
ISl/NEW STRUcrURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
VIL'I~''','' -7'
"U", . c(' f'
. ':1 II I'" '. '.".""'. -
PLUMBING CONTRACTOR' 'C.: :.,:, \.' ,,:,'
. ;i~/ (b'\,~'--------'--II ill
Plumber's Indiana S~"'; ~iceMl4V#" 8 2006 II I,J',!
~ (')ss~0$ Ie) I
. . t' . . ..J I
Which plumbing codes Wfll be apphed to the construction: I
o International ResidentiBI.Code.w/IndiaoaAmendment5
~form Plumbing Code wi Indiana Amendments -_.~
(Multi.Family Construction Code)
TYPE OF CONSTRUCTION:
g/ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release Manufactured FOUNDATION TYPE: (Check all that apply for the new
. / ./ construction area)
Permit: _Y ~N Trusses: _Y ~N
Lot Split: _ Y 0N:"~i"SUrilp Pump: Ly _N 6 ~~:LSPACE ~ ~~~M&E~~M, /
Does any part of the property':li4!:.withilla speqal Flood designation area: _Y _N WALKOLIT:~---.:.....N
For Single F ~~,m@'~~t?J:€~~ls, and/or accessory structures, this permit is valid only if construction commences
within 180 ~Q"d).qd~tH.,~tI:~&<Vrl~iWlt1ip.gJ>&im\Jt~nd ~ust be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I stsP9mfii~tt~cir 'ec~to:m'e'Gelle~I.Ad.rntnistrative Ru~es of the Stat~ of Indiana (See 675 lAC 12) regarding expiration
~. ~J;'~T t'\.r:: . . ~l!'Mtnes for begmmngland completmg constructIOn.
I, the urlffersi ~,ragte~l'lat~mTIlcS~t€56rgem~~,J,,rJl,.[ ocation, or alteration of a structure, or any change in the use of land or
structures r ~Ciiljgs "., e.. ~P~~JWI~fdI [Q,,~:~licable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana -19~~. (Z~ 289)an "amen ~s~ a"C(oP.'fe'Jiu/~f),Ibnc. 360bt seq, General Assembly of the State of Indiana, Jpd all Acts Jmendatory
thereto. I further certify ih'atonly U~and floordrai.n~ are connecte~to the sanitary sewer. I further certify that the cpnstruction will not be
USffiCUPkd un Ii a Certihcate of Occupancy has been Issued by the Department of CommunIty Semces, Carmel. Indl~na
Signature of n~ror'A - ,. .rnfiV-~ l. '13>ee{tS . ~J'{ I 010
'. ',. * *,.:~:~~ ~~~,~:~ * * *- *-~ *.~ * * *- *- * *- *- * *- *- *- * *- *- *- *- *..1 *- *- * ~*- *- * *- *- *-H *- * *- *- *- *- *- *- *- *- *- *- *- *- *-
, 'FIling Fees: Lfl / ~, 70 .'
INSPECTIONS REQUIRED: ? .-:> 3, 0 0 :0.', #Ch;9ed Re-
Base Inspections: "..L ::J ~
Under Slab r-? . ,<.4 Reviews
Cert. of Occu pa ncy: C> ~ J U
P.R.LF.: ! 2. C I (] 0 Additional Fees
-
ts ';) -
ReviewedfAppr ved: Dept. of Community Services
S;Permits!formsjIlP RESIDENTIAL