HomeMy WebLinkAbout06060188 Application
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CIty of Carmel/ Clay Townshtp Permit #: Q4, tJc, () / ~K
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
LOCATION
&. PROJECT
INFO:
STATE
ZIP
BUILDER of
RECORD:
NAME
FAX
I
PROPERTY NAM
OWNER:
STREET ADDRESS
--7'--10
ZIP
q(,p Z-iJI
ZONING:
SEWER UTIUTY
PROVIDER:
- ~~~
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTI WELL A PTIe PERMIT #'5 (IF APPLICABLE):
\
177'
PIUmbJl:j:"i~a~;:
o Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
/'" FOUNDATION TYPE: (Check all that ap.ply for the new
Early Release ./ Manufactured
~ construction area)
Permit: _Y. N...- Trusses: _Y_N
.:;7 .........-z; 0 CRAWLSPACE
Lot Split: _Y _N Sump Pump: _Y'~N 0 SLAB
Does any part of the property lie within a special Flood designation area: _ Y ~
o fQ8T-& BEAM
~BASEMENT ~
WALKOUT:_ Y ---,--N
Fo~ Single Family and Two Family dwelling~, addit' ~b{~~CD~d/or accessory structures, this permit is valid only if construction commences
WIthin 180 days of the date of .L~~a k1.g'~tYiirt\~~n4riRust be completed (Certificate of Occupancy issued) v.rithin 18 months of the
issuance date. Clasf\~'p1kJnft~te\su 'WftW3J1era~'Xdministrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
. t to carllphane i~!;f~6r begin,!lipg and completing construction.
I, the undersigned, aj~mr a~~~t9'arak1, \.Rb'n~C~,~\:olIt' relocation, or alteration of a structure, or any change in the use of land or
structures requested by this app1ft~g.c.Y4U,~~M2J.Nti\:h~ ahtfcon ~lPpplicable la\vs of the State of Indiana, and the "Zoning Ordinance of C~rmel
Indiana - 1993" (Z~ 28 iip~eht~~~~[eq y-n.~t1f~ Il~.E'.'3~~.7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
th~eto. I further eer' t ~i)I\R~?1!!-p&,I" drains are connected to the sanitary sewer. I further certify that the construction v.rill no.t be
used 0 occupied unQ cate of Oc,~een issued b epartmenr of mmunity Services, Carmel, Indiana.. J
. I" 12-7<-i )c,
Print if~~ /
OFFICEUSEONLY:************************************************* * ********************
Filing Fees: ?O
Base Inspections: 0 # Charged Re-
. Reviews
---., Cert. of Occupancy: I') 3. 5'0
Site P.R.I.F.: /(}....G (, (JO . Additional Fees
~ J;1d41/f/i
Fee Received b~
INSPECTIONS REQUIRED:
~~~;,l-1/~ 1-6-60
Reviewed/Appro d: Dept. of Community Services (Date)
S:Permits!forms!ILP RESIDENTIAL
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