HomeMy WebLinkAbout06060190 Application
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City of Carmel/Clay Township Permit#: Ot,n0CJ/tfO
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
:UILDER of
lECORD:
PROPERTY
OWNER:
, LOCATION
& PROJECT
INFO:
SEWER lITIllTY
PROVIDER:
t-Jwb
WATER lJTILlTY
PROVIDER:
FAX
ZIP
SQUARE
FOOTAGE:
3SSs/
59
NAME OF lJTILlTY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET r I
NUMBERS; TAC DATE(S); ANDIOR COUNTY WELL ANDIOR SEPTIC PERMIT #'S (IF APPLICABLE): n <
TYPE OF IMPROVEMENT:
~ STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
TYPE OF CONSTRUCTION:
~LE FAMILY
o TOWN HOME
o TWO FAMILY
# Df units;
o MULTI-FAMILY
# of Units;
o RESIDENTIAL (For
Additions, Remodels, Etc.)
~:Nj "o~it:
Plumber's Indiana State License #:
WJTll
Which plumbing codes will be applied to the construction:
o International Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release /' Manufactured '/_N
Permit: yl../'l../' ~ "sses: ..-y
- - 0 CRAWLSPACE
Lot Split: _Y _ Sump Pump: ~ N 0 SLAB
Does any part of the property lie within a special Flood designation area: _Y L./ N
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o POST & BEAM
~EMENT
WALKOLlT:_ Y ~N
For Single Family and Two Fa_!fY(~p"~~~'Rqld~D1P(o....Tt~ry structures, this permit is valid only if construction commences
within 180 days of the date 0 k&'M t1\~LJffihl: l~~,'incfih'ti'~r.e ~~pleted (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structur tatQ ~~re bPafl}(cfMGM!~ffb~ules of the State of Indiana (See 675 lAC 12) regarding expiration
of Stat&:lfnIihLa66htg~8%.and completing construction.
1, the undersigned, agree that anDEPTfcA:PI, ~qi<PNflTh.rR~_" ,or alteration of a structure, or any change in the use of land or
structures requested by this apcl.if.aQqn,;:::,ill"'cAmJ'k.....Widi; aifci^~ntorm "to:- aI.1 a p. . ~a\Vs of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana _ 1993'" (Z~ 289) and airLiJilnln~ lrd~Melowth\.Vk/t.)'I.Cf. , ~ttJeral Assembly of the State of Indiana, and all Acts amendatory
thereto If rther certify that y kItchen, bath, and qtQf1irAINAe connected to the samtary sewer I further certIfy that the constructIon Wlll not be
used or upled unul a Ce ,heate of Occupancy has seen Issue e Departm:J; CommunIty :::ces, Carmel, Ind.ana ~
OFFICE USE ONLY: ********************************************* * * *
Filing Fees: '
Base Inspections:
Cert. of Oeeu pa ney:
INSPECTIONS REQUIRED:
ower Footing Under Slab
Meter Base C::al ~
~ C' ("(1:"9. 11/;......- -r-b -Oh
l \ Revlewed/Apploved: Dept. of Community SeNlces (Date)
S.Permlts/Forms/llP RESIDENTIAL
P.R.I.F.:
, 70
'73)0
i +-. b I. 00
Additional Fees
rJ, ] 3 (" J()
# Charged Re-
Reviews
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