HomeMy WebLinkAbout06050162 Application
City of Carmel/Clay Township Permit #: Ofe050/f..o ':\
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
JUILDER of
RECORD:
NAM5 k. I
Cor
STREET ADDRESS
3. '63
5.~
PROPERTY
OWNER:
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NAME
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PHONE
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FAX
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LOCATION
& PROJECT
INFO:
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lOT # ;; SUBDIVISION N')M~ !
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STATE
ZIP
5.:...
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NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW OOCKET 1)00 h.1) I. A /J t:..
NUMBERS; TAC DATE(S); ANDIOR COUNTY WELL ANDIOR SEPTIC PERMIT ,'S (IF APPLICABLE):" "'"'~ I
TYPE OF CONSTRUCTION: \ ~ TYPE OF IMPROVEM~TlCl\Ol'l'LUMBING CONTRACTOR: 8(..l.4
o SINGLE FAMILY ~e c::J., ~~IW~~~(~9\J\at\0(1S a
o TOWN HOM~' E,-EJ>.Sey~,_McAD[;)~6~g\il,. Plumber's In~i!"na S~.t'i';lic'!ln~;#:\:;' "~: \,-~: _:
o TWO FAMI f'\. t""O RC'u'A~'" .J.wSl \j\CES 'I!) I" 0 .'co!': ,_. \, __,- I, .
sublec, 'L':l ~,<-' vU u,., '\ ,I" ___u"u__._'''''''__'__'11 \I
o M~~~~~:; LY .,. ~t~~~-~~L~\;{&~N hlchPIUmbing~~~Willbe'PPliedtotheconst,ucti~~:illi
# of Units' OEP\~ ~'_v 1'1 \,1 llA\L ') O.'JMe ,-I,
O RESIDENTIAL (F 0 N ~Q.8~GE 0 International Residential t;oCfe "/IndI~na Amendments
or 9\1'l A"'""mltN:~'ARAGE III III Ii L.J: '
Additions, Remodels, Etc. D~~OUTION 0 Unifonn PI~mbi~od~ w/.!.ndi'!.~~,,!e.".<!pents 1
(Multl-FamIIYjConstructlon Code) I
PROJECT INFORMATION: ~;
E I R I ~ M f ct d :s FOUNDATIO 'TYPE:-(Check~all'thaCappIYfort~enew
ar y e ease anu a ure .
P -t Y N T Y N construction area)
erml : russes:
. - - ~ 0 CRAWLSPACE 0 POST & BEAM
Lot SplIt: _Y Sump Pump: _Y ~N 'W SLAB 0 BASEMENT
Does any part of the property lie within a special Flood designati06 area: _ Y ~ WALKOlIT:_ y.....k..N
A RESS OF CONSTRUCTION
00 S
or J
SEWER lITILITY
PROVIDER:
For Single Family and Two Family dwellings, additions. remodels, and/or accessory structures, this permit is valid only if construction commences
within 180 days of the date of issuance of the building permit, and must be completcd (Certificate of Occupancy issued) within IS months of the
issuance date. Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
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 -1993" (Z~289) and amendments, adopted under authority of l.c. 36-7 et seq, General Asscmbly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen, bath, and floor drains arc connected to the sanitary sewer. I further certify that the construction will not be
used ~r occYfied iJtj\ a enificate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana. _ _
~ /lICit'H" J-f<!J1l1ess,!- :::'/Z,3/b
Signature of Owner or Authorized Age Print Date .
pproved: Dept. of Community Services
s/ILPRESIDEJ'ffIAL
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OFFICE USE ONLY: ** ***** **** *** *** **** * *** ****** * ****** ***** ***** ***********
Filing Fees:
Base Inspections:
Cert. of Occupancy:
INSPECTIONS REQUIRED:
Rough In
Lower Footing Under Slab
Meter Base Final ~
P,R.LF,:
# Charged Re-
~ . Reviews
Addibonal Fees
Upper Footing
~