HomeMy WebLinkAbout06050219 Application
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City of Carmel/ Clay Township Permit #: ()&D:t>;;z.\~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
SEWER UTI
PROVIDER:
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td~q'
ND
BUILDER of
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'$ (IF APPLICABLE):
TY~:;; O~~~L:::~~ON:~ _ oyTYPE
TOWN HOME C)~,.r
1WO FAMILY 0- 0
# of units:
o MULTI-FAMILY 25
# of Units: 0
o RESIDENTIAL (For 0
Additions, Remodels, Etc.) 0
~-t,~'4-
..0
Plumbe~~d~i'\State Lie ~ ~
_\D.P)~ '.J,>.'.>
Which plumbing codes will be applied to the construction: ...
~,.::::---
2 IntematiOnj I ~1~tei'fi4l~~~~~~ents
'f(- Uniform Plu",~l!J~ o(te wfINliani!.A~~e I 1)1
(Multi-Family a?S Ion Code) J~I
PROJECT INFORMATION: ) I
~ FOUNDATIO E: ~ck-8111thab"BPIYf t new
. Early Release Vl Manufactured construction ar L..sll:JM ) I'
Permit: Y ~N Trusses: Y N
- '~ - 0 CRAWLS ACE
Lot Split: _ Y .:z:LN Sump Pump: Y _N ~ SLAB 0 BASE~~: I
Does any part of the property lie within a special Flood designation area: Y N ^~ Y _ N
NEW STRUCTURE
ROOM ADDITION(S)
PORCH ADDITION(S)
REMODEL
ACCESSORY BUILDING
DETACHED GARAGE
ATIACHED GARAGE
DEMOLITION
F IMPROVEMENT:
For Single Family and Two Family dwellings. additions, remodelsLt~GtFssory structures, this permit is valid only if construction commences
within 180 days of the dat"'~is~~k~ef1ll(iJ(j)NStrBw~l~M'c'bmpleted (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structh\~~krK.l!.'bl.tf~t8cW~fI';tlr.bWtu'at.toGSve Rules of the State of Indiana (See 675 lAC 12) regarding expiration
subject to corr\li\\\\l'!F~"les r e!!~\ng and completing construction.
I, the undersigned, agree that any constot:&iB#:a:ci'JFlMrbtt~ ,e l~h5ion, or alteration of a structure, or any change in the use of land or
structures requested by this aPPl~ilfl O\9=~MM-UM11cr;'t{fomw~.YI1 lCable la\'iS of the State of ~ndiana, and the "Zoning Ordinance of Carmel
Indiana -1993" (Z- 289) and a~ehts, ~Op~l ~r t~~fFgW ~cneral Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify tha~tGm, bAthtl 'li&rd~ns arc connected to the samtary sewer. I further certify that the construction will not be
use cupied until a Cert jcat~o[OC<cup'ancxOOlAAl&ed ~y c;~me~si rmel. IndianO h~t-..( (cx.o
Signature of Owner or Authorized Agent Print Date
OFFICEUSEONLY:*************************************************~*****ii***************
Filing Fees: (~~C!. .CJ U
INSPECTIONS REQUIRED: . n M 7 .riD
......ri_~__ ~,-",' Base Inspections: ~. f . v l
c-t'pper Footm~wer Footing~u 5 '? ;CO
~...-""- _..::-? Cert. of Occupancy: ..::::::. . ..::)
~ugh n Meter~inal ~ . O()
_ ~----.:.. P.R.I.F.:
~~<3?- 0
-6 ;.?.;< 2A
# Chatged Re-
ReViews
Add;bonal Fees
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Reviewed/Appr ed: Dept. of Community Services (Date)
S;Permits/Forms!ILP RESIDENTIAL