HomeMy WebLinkAbout06060140 Application
City of Carmel/Clay Township ~ Permit#: OfoO(POll..(o
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, 8< Two Family: New Structures, Additions, Remodels, 8< Accessory Structures
BUILDER of
RECORD:
\JC. '10"'>
PHONE
.01
FAX
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STATE
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CITY
BUILDER'S EMAIl ADDRESS
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BEST METHOD OF CONTACT:
LOCATION
8< PROJECT
INFO:
'-'
PHONE
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CITY
o
~
FAX
PROPERTY
OWNER:
NAME
I
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,
STATE
ZIP
u.
LOT #
SECTION
ZONING: S
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ADDRESS OF CONSTRUcnON
S.t..i'\~
SQUARE
FOOTAGE: 6:>'0:::;> (>
SEWER UTILITY
PROVIDER: C'..AA~\r;.......
WATER UTILITY
PROVIDER:
ESTIMATED COST OF CONSTRumON:.a-t
(EXCLUDING LAND VALUE) 1;1. to \ ~o ~ f.\.J
NAME OF UTIlTIY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITION(S)
0/ PORCH ADDITION(S)
IKI REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
PLUMBING CO NT
II
Plumber's Indiana
TYPE OF CONSTRUCTION:
rJ!f SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
Which plumbing codes
o International Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release ~ Manufactured / FOUND~TION TYPE: (Check all that apply for the new
P.t Y N T Y. N constructIon area)
erml : . russes:
- ,/; / - 0 CRAWLSPACE 0 "-pOST & BEAM ~
Lot Split: _Y ~N Sump Pump: _Y _N 0 SLAB .. .-- / [sf BASEMENT
Does any part of the property lie within a special Flood designation a' Ibtt-N WALKOUT:_ Y_N
For Single Family and Two Family dwellings, additRi , ,nH!t!f aC8~~tr>>QtlBg1i\~~&mit is valid only if construction commences
within 180 days of the date of issuance of the buil(~:Stiti,6Q)\itP\fM'~i&Q 'lom ~tg.ificate of Occupancy issued) within 18 months ofthe
issuance date. Class I structure permits are subject tothe'Gen~d.te~rrw ~e~ ~J~~diana (See 675 lAC 12) regarding expiration
time ft,,-m..;;w ~e1(!lMM\ll1IPleblg ry,~1I"o!\...",
I, the undersigned, agree that any construction, reconst~,le~ijefi'i.s..i"(t~lif.lrc<f~ "'"'iter0WJNSmMture, or any change in the use of land or
structures requested by this application \\ill comply vvjtq'1tf\ll ~~~d'aB'Ye'rnws o( the State of Indiana, and the "Zoning Ordinance of Carmel
In . ana - 199r (Z~ 289) and amendments, adopted un~laLthority of l.c. 36-M'B:~Aral Assembly of the State of Indiana, and all Acts amendatory
th eta. 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, Carmel, Indiana.
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Print
loa - ;}(l - tx-
Date
Sig ature of 0
OFFICE
*******************************************'~~*********************
Filing Fees: L.5 :; , SO
INSPECTIONS REQUIRED: / / /. CO
Base Inspections: '- _ _
Upper Footing Lower Footing Under Slab
Cert. of Occupancy: -:>.3. S7)
GughI0Meter Base~al ~
.
CI('-6 ; Q /1;i.sLr ~ -Z,0-C6
Reviewe'd/Approv&d: Dept. of Community Services (Date)
S:Permits/Forms/llP RESIDENTIAL
# Charged Re-
Reviews
P'R.I.>~.
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Additional Fees
Fee Received by: