HomeMy WebLinkAbout06050201 Application
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.~. " City of Carmel/Clay Township Permit #:U't) ") v 0
~. RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
'''00 " For Single Family, Multi-Family, & TWo Family: New Structures, Additions, Remodels, & Accessory structures
BUILDER of
RECORD:
lit. Stt;rc
I
PROPERTY
OWNER:
BUILDER'S EMAlL ADDRESS
Ib' SONG
NAME
D
STATE
IN
BEST METHDD OF CONTACT:
ZIP
'1/"J.. "6
PHONE
FAX
STREET ADDRESS
LOCATION
& PROJECT
INFO:
SITe ;).00
CITY
I
STATE
IN
ZIP
I/.d~
ZONING:
$-
SECTION
a
SQUARE
FOOTAGE:
/'7
SEWER UTJUTY
PROVIDER: C I
NAME OF UTJUTY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOC1<ET
NUMBERS; TAC DATE(S); ANDIOR COUNTY WELL ANDIOR SEPTIC PERMIT #'S (IF APPUCABLE):
ESTIMATED COST OF CONSD.ucrrON:
(EXCLUDING LAND VALUE) 115 'f
TYPE OF CONSTRUCTION:
o SINGLE FAMILY ~ :\,
o TOWN HOME P"
o TWO FAMILY ~\ t\.
# of units: r '
~ULT1-FAMILY
# of Units:
RESIDENTIAL (For
Additions, Remodels, Etc.)
J"t>
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
~OOM ADDffiON(S)
o PORCH ADDffiON(S)
REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
PROJECT INFORMATION:
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is valid only if construction commences
within 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structure pennits 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 I.c. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
us or occupied until a Certificate of Occupancy has been issued by the Department of Community Services, Cannel, Indiana.
() , .
, . D - . 1..<"12', A. B;Il.\)SONG--IkW;",lI:
Signature of Owner or Authorized Print
sh,L/ )l'k
Date
OFFICE USE ONLY: *********************************. *. **.. *. *******~*4.******A*****************
. e Filing Fees:. /::,) d., 6' CL
INSPECTlONSREQUIRED: 1(,1(3 B~~e:J~;~~f:OR CO~ # Charged Re-
Upper Footing Lower Footing Under Slab :3U9J.lCi'!;:to. compliance w. U I\lRS Reviews
Cert, of Q5l:9IlR\!CiVMcl ,,~ ~ __~
~ Meter Base ~ Site p!R!'i~);OF;c'Q~1~~~4~4i~ER\lICES
O CITY OP:CAR. MEU),
'. .,J~.
'.,J.... .
Reviewed/Approved: D pt of Community Services (Date)
S:Petmlts/Forms/ILP RESIDE
Additional Fees
Fee Recelv
coNDITIONAL