HomeMy WebLinkAbout06070068 Application
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City of~el/Clay Township Permit #: () ~070fk1J.
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
G
E
P~ON
3\7-
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~O\'fN'
FAX
3D-
ZIP
4
STATE
hra.
PROPERTY
OWNER:
FAX
11.\ -793 -Otyll
u3~
~N~
LOCATION
&. PROJECT
INFO:
SEWER UTILITY ATER UTlLIR"
PROVIDER: PROVIDER; '- t-\-
NAME OF UTILITY EXCAVATION CONTRAcrOR; PLAN COMMISSION BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
ESTIMATED COST OF CONSTRumON:
(EXCLUDING LAND VALUE) &0 Cil
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME 0 ROOM ADDITION(S)
o 1WO FAMILY RELE ..P. PORCH ADDITION(S)
/# of Unlts:.p AS ED FOrd.~~bJCTl
CY' MULTl-FAMIL ~oJect to compiiar0a vIi(jimBji~ L auR&lNG Which plumbing codes will be applied to the construction:
# of Units: ~ of State and]]odil ' ~WA'G!: 0 International Residential Code w/Indiana Amendments
o RESIDENTIALQ!OPT OF COM~ "~~I ARAGE
Additions, ~~~tt)^R N D 101.' CES ClYUniform Plumbing Code w/Indiana Amendments
" MEL C TO (Multi-Family Construction Code)
PROJECT INFORMATION: INDIANA WNSH/P
Early Release Manufactured FOUNDATION TYPE: (Check all that apply for the new
Permit: _Y VN Trusses: _Y ...........N construction area)
. L 0 CRAWLSPACE
Lot Split: _ Y ~N Sump Pump: _ Y &./N ~LAB
Does any part of the property lie within a special Flood designation area: _ Y .......-N
\fo\~- ~elc\
PLUMBING CONTRACTOR:
t:h \\\~'(\;('(I\
Plumber's Indiana State License #:
\W7lAo3
o
o
POST & BEAM
BASEMENT
WALKOUT:_ Y ""'--N
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 IS months of the
issuance date. Class I structure permits arc 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 \vith, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 199r (Z~ 289) and amendments, adopted under authority of I.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
t o. 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
sed 0 occupi mil a Ceryfi te of Occupancy has been i,"ued by t De\tmc~~~(~ty Services, Carmel, Indiana. 711~ I O(p
t Print Date
E USE ONLY: ************************************************J!**********************
Filing Fees: J/fS:L. 00
INSPECTIONS REQUIRED: / A 0 A . 0 0
.....--;;: ~ .....c::::: ?"\ Base Inspections: (g U.
"-- Upper Fo~g Lower Footing ~nder Slav ?v / If , 0 0
=-=-~ - Cert. of Occupancy: __
~ MeterR~ ~ 50lftJrOO
P,R.I.F.: L
-Ii ~ 315.00
17, ~;! 1(0l~
# Charged Re-
Reviews
Additional Fees
, ~ TOTAL:
;260 .-t..
A./'l{)
Fee Recei ed by. -
7/7 t,/O(.
r I