HomeMy WebLinkAbout06060146 Application
City of Carmel/Clay Township V~permit #:Oc:'00 0 ILl (p
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, 8r. Two Family: New Structures, Additions, Remodels, 8r. Accessory Structures
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET e..\.. 't:.. i ! I ) i r[ - ...
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE): I i l.; \
I
PLUMBING C
'2.~\ ~~~
Plumber's And ana State
\\::::>5 "I
PROJECT INFORMATION:
Early Release ~ r Manufactured..J
Permit: _Y ~N Trusses: ~Y_N
.....1 "- 0 CRAWLSPACE P POST & BEAM
Lot Split: _Y ~N Sump Pump: ..f..2-Y _N 0 SLAB ~ BASEMENT
Does any part of the property lie within a special Flood desi nation area: _ Y ~N WALKOUT:_ Y IN
For Single Family and ~.@AS&,gli~a.. 0 e 5, n ccessory structures, this permit is valid only if construction commences
within 180 days of the ~~r...llf6'rt6I9m~tnolaU4tt;t it~~~ ust e completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I st~Mtf~~perovi~~~~ef:tooa~Cadefl,Adrninistrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
Il ki,rQ/t {~~fl\i'Gms completing construction.
I, the undersigned, agree tOO~'toQiuQQ,IY!~~h\o~ L~~rnntt.llfIption, or alteration of a structure, or any change in the use of land or
structures requested by t~~i~~NlElv.pr(i;\uAilo ~~d,'MfjP'~tic<}ble laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - I993~ (Z- 289) ~I!nln'ttfrlen~,' adoPM ~pA.INf.lAhority 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,IINM1~ ~ins are connected to the sanitary sewer. I further certify that the construction will not be
used or occupied until a Certificate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
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OFFICE USE ONLY: **************************.~** *** *************J*i!>.~'*P1~****************
Filing Fees: t2cE...--.. :LJl.
INSPECTIONS REQUIRED: )
c -~ _ ~ Base Inspections: --:--/77 ,t(O # Charged Re-
C Upper Footing o..wer Footing Under Slab .'--' :)'() ReViews
. Cert of Occupancy: " .3,
CROlighi~te~0al~ PKLF,: IJ'6/J;.(). Additional Fees
~~ ~ ~;{;~ 'It)
Fee Reee;v by: ~ I
BUILDER of
RECORD:
N~
STREET ADDRESS
q~'d-
'd.~~~
BUILDER'S EMAIL ADDRESS
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PROPERTY
OWNER:
NAME
STREET ADDRESS
qaCl~
:\-
LOCATION
8r. PROJECT
INFO:
LOT #
ADDRESS OF CONSTRUCTlON
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\e ~~
WA RUmm ()" 0 0 /1.( '1
PROVIDER: c...~~
SEWER UTILITY
PROVIDER: c...~
TYPE OF CONSTRUCTION:
-rB. SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
)Q NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
i~~\
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Reviewed/Appro ed: Dept. of Community Services
S:Permits!formsjILP RESIDENTIAL
(Date)
"'
PHONE
<:64 ~-'151 '-\
cTh1)i~
FAX
~W-")(), Y
STATE
J)t<.l
ZIP
4"'~4>0
BEST METHOD OF CONTACT:
~...~
PHONE
"b'-''''!:.~'5 ''-\
FAX
<r 18 --''IT!
cm
STATE
ZIP
<\\oalp!l>
1-4
SECTlON
\
ZONING:
"'~ 11\
SQUARE
FOOTAGE: ~C\ '51
ESTIMATEDrffis:t-Of-C{)N5TRl:JGrlON~---'---~
(EXCLUDING R\f:l\l. 'iACDE)ci:::-i. \''';-;1. -'> <:Y rr:~' i;~
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Icense #:
Which plumbing codes will be applied to the construction:
o International Residential Code wjIndiana Amendments
rsJ Uniform Plumbing Code w/Indiana Amendments .
(Multi'Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)