HomeMy WebLinkAbout06060096 Application
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City of Carmell Clay Township c:- tJ\ Permit #: OldO~ b1)q V
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME
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STREET ADDRE9) ,q
PROPERTY
OWNER:
BUILDER'S EMAIL DDRESS
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NAME Mil,
STREET ADDRESS
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PHONE
FAX
::tIJATE
, //_ ZIP
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ITY
SEmON
ZONING:
S
LOCATION
&. PROJECT
INFO:
SUBDIVISION N~E _
1441 cr~
ADDRESS OF ?!RUCrI4Vot:c:r IJ-/'
LOT #
SEWER lJTILITY
PROVIDER:
~/.I~JJ
SQUARE I" // /'
FOOTAGE: -r-r
WATER UTILITY
PROVIDER:
ESTIMATED COST OF CONSTR
(EXCLUDING LAND VALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PlAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); ANDfOR COUNTY WELL ANDfOR SEPTIC PERMIT #'S (IF APPLICABLE):
PROJECT INFORMATION:
Early Release Manufactured ___ FOUNDATION TYPE:
_Y _N _Y _"" 'N construction area)
Permit: Trusses: ./
o CRAWLSPACE [O"j POST & BEAM
Lot Split: _Y _N Sump Pump: _Y vN 0 SLAB 0 BASEMENT
Does any part of the property lie within a ;~m\@lIIesignation area: _Y ~ WALKOUT:_ Y ~N
For Single Family~, ,<8),. ~!'n~ \d~~~l it, '.4Ain~.~Q,\j!i ~~and/or accessory structures, this permit is valid only if construction commences
within 180 days O{}:hD~~ ~iQtilaf1~\ .,~. areJ$~it,,and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Classq~ta;cturo~te ate:' , > , e~t,4A.J~'~.~~GS&nistrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
- - CO\'\i\M ,~~1n1~!Orcbi;~~ptdcompletingconstruction.
I, the undersigned, a~aJ;Jfc,n'rl..!~cI~' .~~ti"iliQWt~ent, relocation, or alteration of a structure, or any change in the use of land or
structures requested py\t):I.ij ~.@.~ ~\n I wi~h, and conform to, all applicable laws of the State of Indiana, and the "'Zoning Ordinance of Carmel
Indiana - 1993~ (Z~299-) Jn~ am~ndments:awID ,. [1.aurhority of r.C 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I certify at only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
u a Certificate of Occupancy has been Jssue~e Dep7~::;=muntty ServIces, Carmel, Ind,.na ~;I ~
th rized Agent Int ~ Date
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
~ RESIDENTIAL (For
Additions, Remodels, Etc,)
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITION(S)
~PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
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Plumber's Indiana'statEHicens It<' '" "-
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Which plumbing codes will be apPtie(j,~~~~~constr ctiO~ /
o International Residential c~di;'t;iilndiana Aj1I nd~ts
" ",~IJ ;::,., / /' "'1"
o Uniform Plumbing Code w/Indian7A111'l!ndo.ents
(Multi-Family Construction Code) '~' (I .(/.;1'
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(Check all that apply for the new
Final
*******************************************
Fees: /SO. 7(P
/ (, C;, S-- 6 # Charged Re-
, Reviews
Cert of Occupancy: ,)'3, 5'()
OFFI
E ****************
INSPEcnONS REQUIRED:
Under Sla
Site
Additional Fees
P.R.LF.:
~ti ~f;~
7,?
{., -/ ~15
Reviewed/App ved: Dept. of Community Services (Date)
S:Permits/Forms/llP RESIDENTIAL
Fee Received by: