HomeMy WebLinkAbout06060159 Application
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City of Carmel/Clay Township Permit #: ~liO~ /.:y I
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
FAX;3'7.5'75'-V9~
BUILDER'S EMAIL ADDRESS
:s STATEfN ZIP ~O
BEST METHOD OF CONTACT: (<oB 0
7-?3r- If.
PROPERTY
OWNER:
NAME
PHONE
FAX
STREET ADDRESS
cm
STATE
ZIP
TYPE OF CONSTRUCTION:
t!i( SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
LOCATION
&. PROJECT
INFO:
LOT #
SUBDIVISION NAME
SECTION 3
Ef2.
NAME OF UTlLm EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
~
TYPE OF IMPROVEMENT:
~ NEW STRUCTURE
o ROOM ADDmON(S)
o PORCH ADDmON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
o Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE (Check all that apply for the new
::~~i~elease _Y LN ~r~~~~~ured _Y LN construction area) :
V X Q!;! CRAWLSPACE 0 POST & BEAM
Lot Split: _Y ~N Sump Pump: _Y _N 0 SLAB 0 BASEMENT
Does any part ofthe property lie within a special Flood designation area: _Y XN WALKOUT:_Y X N
For Single FamA'~~~ ,a ii, :\ andlor accessory structures, this pennit is valid only if construction commences
within 180 da!'4B~~w:@~roetMutuMiftiil t~ ~~ must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. C[ass-t stru6f9ififfiDH~~y~a~.General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
(lP, JI ~A I I t\1 F~ fQ.toA~ing and completing construction.
I, the undersigned)ij:PethG fu~bf'fM%H:to'rl,l~tohst1u~op,..e~t, relocation, or alteration of a structure, or any change in the use of land or
structures requ~<tV tifll1fl'JA~fiWl f~ti[I..I~'i~\:IJ. all applicable laws of the State of Indiana, and tbe "Zoning Ordinance of Carmel
. In.diana -1993n cr~"2~g) and aIDeD.dni~'~~~i<<Wnder authority of l.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto: I further certify that only kitcl\8i.,4.'Bm~ l&llloor drains are connected to the sanitary sewer. I further certify that the construction will not be
used occupied til ert" te of Occupancy has been issue~ the Department of Community Services, Carmel, Indiana.
'CoB .!tUGHENBIJU6f1- G/J1..vf()f,
or ed Agent Print Da~
OFFICEUSEONLY:****************-e;*~*******************************J!-******************
(" % J Filing Fees: b- ff -::fQ
INSPECTIONS REQUIRED: '1 '7
_ . It Base Inspections: '7;:;2 0<-. a 0 # Charged Re.
~ Lower Footing Un lab ~ '-:;1) Reviews
~ - Cert. of Occupancy: ,S 3..)
~h~_~eter Ba::> F' P.R.I.F,: /;< (, I 00 ,
~~'I:r~t4~::(:!;;0 {,
~dbY: ( ~
Additional Fees
C',rd ~~ His..eA' 6-'2~-~{
Reviewed/App "ed: Dept. of Community Services (Date)
S:Permtts/Fonns/ILP RESIDENTIAL