HomeMy WebLinkAbout06050144 Application
City of Carmel/Clay Township ~ermit #:ObD50 )1!+
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME
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STREET ADDRESS
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BUILDER'S EMAIL ADDRESS
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PROPERTY
OWNER:
STREET ADDRESS
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LOCATION
&. PROJECT
INFO:
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SEWER UTILITY
PROVIDER:
LOT #
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ADDRESS OF CONSTRUCTION
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WATER UTILITY
PROVIDER:
NAME OF LmLfTY EXCAVATION CONTRAcrOR; PLA
NUMBERS; TAC DATE(S); AND/OR COUNTY W
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PHONE
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STATE
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BEST METHOD OF CONTACT:
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PHONE
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FAX
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CITY
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STATE
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ZIP
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SQUARE
FOOTAGE: 1:) 'ifiS)1
ESTIMATED COST OF CONSTRUCTION:" (), a "'0
(EXCLUDING LAND VALUE) d. 0- , \. '-J
SECTION
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PLUMBING cONTRAcToR::ij:cbOSO/4-3
PI~:'J;In~r;'n':i~t~t~~ #7
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Which plumbing codes will be applied to the construction:
"0International Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release -/' Manufactured ~ FOUNDATION TYPE:
P.t Y:z T Y N constructIon area)
erml : russes:
. - - / - 0 CRAWLSPACE
Lot Spht: _Y N Sump Pump: v--Y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _Y LN
(Check all that apply for the new
g.. POST & BEAM
~ BASEMENT /
WALKOUT:_ Y..!lL.-N
For Single Family and Two R6hBASffi-fl, ~e<!1N~~fIJ~~~sory structures, this permit is valid only if construction commences
within 180 days of the dat~t1JfJCfCfO06.cm.~Wl~~p.eq"Q.~ \\'M."rh\rl;~ ~~pleted (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits 1T;e: s~.H 1l:'ft6'tHe~i;kftU."" j ~. ~~.~e Rules of the State of Indiana (See 675 lAC 12) regarding expiration
91 ~'~t ~~.~~~~ng ~n.d completing construction.
I, the undersigned, agree that ~(~O~~k119.fjfvg' .' ~W'~ion, or alteration of a structure, Of any change in the use of land or
s~ctures requested by thiSG~~'tiM-~~ith1~'CQ.~ forquo:Ma. ble laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993" (Z~ 289) and arrienc!m~~~': )rl5p~fit:fer1a~ offl~.\iV~ ' WfR;eneral Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen, bath, arUtmANA are connecte9.'to the sanitary sewer. I further certify that the construction will not be
used or occupied until a . icate of Occupancy has b~en issue9. by the Department of Community Services. Carmel, Indiana.
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S' Print U ~ Date
OFFICEUSEONLY:**************************************************~*~*******************
. . Filing Fees: c;;z.-?1 elL)
INSPECTIONS REQUIRED:' ,
Base Inspections: 71? 6'0 # Charged Re-
lab, 0 ReViews
. 'Cert, of Occupancy: .s--3. ,)0
, /;;.. /
P.RJ.F.: b Additional Fees
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(2 5-
ReviewedjAppr ed: ept. of Community Services (Date)
S:PermitsjFormS/ILP RESIDENTIAL
Fee Received by:
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