HomeMy WebLinkAbout06050135 Application
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BUILDER of
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
SEWER UTILITY
PROVIDER: CL.:t
City of Carmel/Clay Township WCo,~' permit#:O&06CJ/3s
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLIC~TION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory St~uctures
NAME .<'" H -r.
'4 AA..." ,I h 0 ,.v...J.
FAX
PHONE
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STREET ADDRESS A.
I 21.-4 Ct-Ift/{torrUJti<S(JeQ ue.
ClTY
LJ~~
STATE
N
BUILDER'S EMAIL ADDRESS
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BEST METHOD OF CONTACT:
NAMEG
PHONE
3n) -S(,,(;o-9J'C( 3
FAX
/I, Tltt....M
STREET ADORES CITY STATE
11-22-1 CJl4a-/~('j L,)/(/:5f>1::W- i)~. LvCSTHCl.l> J:it/
LOT # SUBDIVISION NAME SECTION
.3 7 i??et+fjO'-1f /l-T ~Ab(E Ce"T/<
ZIP
1(.071-
ADDRESS OF CONSTRUCTION
S/.) <>? e- 4:5 ~e, 0 Ve-
SQUARE
FOOTAGE: 8>OOS'ft:"r
ESTIMATED COST OF CONSTRUCTION: .&
(EXCLUDING LAND VALUE) ,if'S. 0 () O. ('J 0
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE{S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
I< ~/()""-r~
WATER UTILITY
PROVIDER: Wm Q.
r"~-'-M-' ,..---, . . .'"'-:-:;-.~::::':-"=:~':--"'
I r r:! rP'.::;, I c::; h ',\.1/ : (:.--:~' i ......\ \
II L=--...";.l\~.-'i~ :":::.::1\,\-,;
TYPE OF IMPROVEMENT: PLUMBING CON . OR:- -II i Ii!
- ; I III
'I ili
o NEWSTRUCfURE iil Ii'!
o ROOM ADDmON(S) Plumber's Indiana II I i
o PORCH ADDmON(S) , 1101
Kf REMODEL I I I
o ACCESSORY BUILDING Which plumbing codes wil' be applied to the construction: I J
o DETACHED GARAGE 0 International Residentla' ,"oae '\VTIiilIIlI1'Ia-Alffint'Ctrrrents
is ~~~L~~~O~ARAGE 0 Uniform Plumbing Code wfInd~~ Amendments
E CIlltlt'~ OON@il~j1'
RELEASe . .~\\ regulations
Manufactured SUbleFO"'~ro t:06~%~Ck all that apply for the new
_Y K-N Trusses: _Y KN cog~~~rrY ~~b9i~~M
Lot Split: _Y )\ N Sump Pump: _Y ~N DEPT FJC1lJ\'MEL/ CLAY ~VI\"'~Mg~n
Does any part of the property lie within a special Flood desgl.~oc;? area: ---\N1!l~ WALKOUT:_ Y K-N
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units;
o MULTI-FAMILY
# of Units;
~ RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit:
For Single Family and Two Family dwellings, additions, remodels. and/or accessory structures, this permit is valid only if construction commences
within 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
time frames for beginning and completing construction.
I. the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or
structures requested by this application will comply with, and confonn to, all applicable laws of the State of Indiana, and the ~Zoning Ordinance of Carmel
Indiana - 1993~ (Z- 289) and amendments, adopted under authority of r.c 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
used or occup,ed u~tiliCate of Occupancy has heen Issued by the Depattment of Commumty Secv.ces, Carmel, IndIana
Own:rorAuthoriZedAgent P~.q~y fI, 1It()"'~J D~7(Of
OFFICE USE ONLY: ******************************* ********* ******I*1'3.****~**********;t'******
Filing Fees: :J., ,-:l 0
INSPECTIONS REQUIRED: J / /. (} 0 # Charged Re-
Base Inspections: _
Upper Footing Lower Footing Under Slab . 3 ~ (} Reviews
Cert. of Occupancy: :5 .)
ROU~ Meter Base
Additional Fees
P.R.LF.:
/tOTAL:_ yf;z. i'tf dO
~- ~'/7 L~)(/" / / ~
' / ~,/. /,.; ,-' J",-
{/ ('c- {LV' /,r.J/(-~" i ~
Fee Received by: \J/ C/~_.
Revie ed/Approved: Dept. of Community Services (Date)
S:PermitsjFOfmsjILP RESIDENTIAL