HomeMy WebLinkAbout06080020 Application
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City of Carmel/Clay Township If' ~ - Permit #: O{"Q ~OO ;;).()
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, 8< Two Family: New Structures, Additions, Remodels, 8< Accessory Structures
BUILDER of NAME cSTR\ D<::c \-k.M<:~ PHONE C;G 9- 8 <;'0 FAX 815 - Z SI'L-
<::"..J!.>TOK
RECORD:
STREET ADDRESS CITY STATE ZIP 4<"O}L
143"0 c.<-A'f TEIG'1A<.C: GAf/-I-'tOL IN
BUILDER'S EMAIL ADDRESS O""'~f' €,,,-,,+--;~.,,,<-k- BEST METHOD OF CONTACT:
/i2-"""';"'" \
PROPERTY NAME PHONE FAX
5AMe A5 At)()o'c
OWNER:
STREET ADDRESS CITY STATE ZIP
LOCATION LOT # SUBDIVISION NAME SECTION ZONING:
8< PROJECT 1- VIL-LA4c of ~~50t < '-A'f
INFO: ADDRESS OF CONSTRUCTION SQUARE ..-.
, 3 >3 4 ;\Bcc,,-,,-,,"',J $I. ~ ^ FO,:!~~E,-_<? 52_~
---'.-..-- ....-_.__._.~
SEWER UTILITY I WATER UTILITY '"'WV V~ ESnMATEO COST:OF-20ri5IRUCij9Nl~:8~j!;;' ! ~W\\ i
PROVIDER: "-<-AT PROVIDER; ~cL.- (EXCLUDING LANa XALUE)--~ _::::::---- ~ T- =-1 I \ 'i
,;! IJ , ,Il
NAME OF UTIUTY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET ~ ~ \ '--' j ill )Ii
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE,f .~, ,~ n we' '-~ 2006
, II iI
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TYPE OF IMPROVEMENT:
'IKf NEW STRUCTURE
10 ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
PLUMBING CONliRACTOR:
I -
n~ ~
r-' }-'l.oo~~
Plumber's Indiana State-t1cens~,#:
.-J~-' I
I
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
1005'2...'0
Which plumbing codes will be applied to the construction:
~ International Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release
Permit:
_Y..LN
Manufactured
Trusses:
FOUNDATION TYPE: (Check all that apply for the new
construction area)
-JS-Y N
- 0 CRAWLSPACE 0 POST & BEAM
Lot Split: _Y -fLN Sump Pump: ~_N 0 SLAB @- BASEMENT
Does any part of the property lie within a special ,o~/ir.ill~ a: Y -XN WALKOlJT: Y ~N
For Single Family and Two Family dwellings, additions, remodels, a~ttrt;??~~..,~rn.res, ltfa:ra;;"'lid only if construction commences
within 180 days of the date of issuance of the building pc6H!Prr.IfQ,~'tbtt~9s91~gr'tifiL:te'rntQ c cy issued) within 18 months of the
issuance date. Class I structure permits are subject to t~l3f~~drlf1n€~' it s'tfP{lG_!~rt~ (See 675 lAC 12) regarding expiration
time framm~rt~61"~~rn ~~}.Qn.
I, the undersigned, agree that any construction, reconstruction, enlargement, I~~ fofillte.f'll}arlfjffiflt~ or any change in the use of land or
structures requested by this application will comply with, and conform to, all apJ:llg.fblj:la~h{f\li.e Jf@:~\I~~~ and the ~Zoning Ordinance of Carmel
Indiana - 1993" (Z~ 289) and amendments, adopted under authority of LC. 36~7 etseq~WA\ssembly or fhWflUPf 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 occupied until a Certificate of Occupancy has been issued by the Department of Community Services, Carmel,Indiana.
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1-/7.4/01"
Date
Signature of Owner or Authorized Agent
Print
OFFICE USE ONLY: ****** *************** *****.~************* *****7~**1I.?5**~(j**************
Filing Fees: ~'~ l-fl-- 0
INSPECTIONS REQUIRED: 7 /0
< '- Base Inspections: ;)7 _ ) # Charged Re-
C U~per FO)l)l:I r D ReViews
Cert. of Occupancy: J 3 - .:51
~ G~ P.R.LF.: / cl--G( ()O AddlbonalFees
fd (TQ!AV -J&~ 80
ReviewedlApproved: Dept. of Community Services (Oate) ~_
S:Permits/FormS/ILP RESIDENTIAL Fee Received by
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