HomeMy WebLinkAbout06050170 Application
City ofCarme//Clay Township Permit #:0 (PO 5 OJ 7 D
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
REC-oRD:
NAME
IJ.....
Co
PROPERTY
OWNER:
BUILDER'S EMAIL ADDRESS
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NAME \
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STREET ADDRESS
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LOCATION
&. PROJECT
INFO:
~
o
o
IMPROVEMENT:
NEW STRUCTURE
ROOM ADDITION(S)
D/,PORCH ADDITION(S)
rl!f REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
PHONE
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CITY
FAX
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STATE
ZIP
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BEST METHOD OF CONTACT:
PHONE
n e,ILo \084>
FAX
CITY
STATE
~J....).
ZIP
""'~03?-
Sa.
711
SECTION
ZONING:
SQUARE
FOOTAGE: ('5o~
ESTIMATED COST OF CONSTRUcnON:
(EXCLUDING LAND VALUE)
\0 500
coil
PLUMBING CONTRACTOR:
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
o International Residential Code w/lndiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release / Manufactured /
Permit: Y L];J:; Trusses: _ Y -LN
Lot Split: - Y 2N~ 'Sump Pump: ..L Y N 8 ~~:LSPACE /
Does any part of the property lie within a special Flood designation area: _ Y -.LN
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o ~ST & BEAM
[8f BASEMENT /
WALKOUT:_ y-LN
Fo~ Single Famil~ . ~i\n~mllY..C!.."Y:e Inl&.sd~, l[iqpsl:"r.~mo ensr'\.~nd/or accessory structures, this permit is valid only if construction commences
WIthin 180 days~l ~~t~MsollT1t~gHfll!'1j i &\~J~WTHft IMlcMnust be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I struc~~~atA\i~1sGfijad:tG9>OO!i:;eneral Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
DEP~ OF COMM U~Sl!f1VG.ng and completing construction.
I, the undersigneA~ yI. ~*?9itIJ.1Cfi~F,'~foR:~~t;.iQfl... f e t, relocation, or alteration of a structure, or any change in the use of land or
srruc~.r~ requesM! ~id' Iippw~~iJ~ptA;\\ilh,~'t~1 ,aU applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
. Indiana - 1993" (Z-289) and amendment~tNJl\lder authority of l.c. 36,7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
-the to. 1 further certify that only kitchen, bath, and floor drains are connected to rhe sanitary sewer. I further certify that the construction will not be
use or occupied until a Certificate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
.~- -
Signature of
-I E. ~t-r<' ~ - v...,,-6e.-.\ <,
Print
Date
OFFICEUSEONLY:***********************************************,*~****~~****************
Filing Fees: / ~ 3. ->u
INSPECTIONS REQUIRED: /' / /. (j A
Base Inspections: ~ _ ~ v
Upper Footing Lower Footing Under Slab 53. ~/)
Cert. of Occupancy: ..) (/
~gh ~ Meter Base ~,site~
C/~ P.R.I.F.:
TOTAL: .P c?!FtJO
(i~*t! 1t~t2rh~ t,/~/tf~
.:.\
,
C'r/k.:~ Hlu.-./ '5-3/-06
ReviewedjApp ved: Dept. of Commumty Services (Date)
S:PermitsfFormsfILP RESIDENTIAL
'S-~Lc(..
# Charged Re-
Reviews
Additional Fees