HomeMy WebLinkAbout06080027 Application
C' rc50b., !. kg-,
City of Carmell Clay Town'Sfut'/ I uJ ~ ;ermit #:OhO 8 tI?:;;' 7
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of . E f-.i PHONE FAX
RECORD:
~EET ADDiJj . ~8.... l)~ J STA~ ZIP
BUILDER'S EMAIL ADDRESS BESTMCA.~rAcr~
PROPERTY FAX
OWNER: A\e.t..I. D T 2-7
Q.f2mS Dt cm L-{ ICJZB -2:..TE ZIP
LOCATION SECTlON
&. PROJECT
INFO: SQUARE
FOOTAGE:
WATERlITILm~ ESDMATED COST OF CONSTRUCTlON:
PROVIDER: (EXClUDING LAND VALUE)
NAME OF lITILm EXCAVATION CONTRAcroR; PLAN COMMISSION / BZA / BPW DOCKEr
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
~.w J:OONSTRUCTION: TYPE OF IMPROVEMENT:
.JI!!:r ~INGLE FAMILY 0 NEW STRUCTURE
o TOWN HOME 0 ROOM ADJ:1. S)
o TWOFAMILY 0 ~CH
# of units: if REMODEL
o MULTI-FAMILY 0 ACC~S Y BUI~ rnpli~hl ~M'f"Willb.'PPll.dtoth.con"r"ction:
M R~~6~~~L (For 0 ~~ i~ an[jf~~iJlnllin~3;r~a' COde.W/Indiana Amendments
f'J Additions, Remodels, Etc.) 8 DEMOUTlON 4'" 11I!~vf1J~~'V~mbiliiPoede w/Indlana Amendments
~ rtMCL I a;&r:~Construction Code)
PROJECT INFORMATION: )JvDI.~~;oI'(VI .
Early Release Manufactured /. cti .": (Check all that apply for the new
Permit: Y . LV Trusses: Y ~c n on area ,...
. - v.. - - 0 CRAWLSPACE 0 POs:r& BEAM
Lot Spirt: _Y _N Sump Pump: _Y _ 0 SLAB ~EMENT /
Does any part of the property lie within a special Flood designation area: _ Y _N WALKOUT:_ Y ~~ .~ ._.\
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is vaJid onlYA-coiist~;io~,~riI:riine~~~\\ ,\' \
within 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occuparicy'i~,u~~):~~~}~inohths ofihe \ \ \ \ \\
issuance date. Class I structure permits are subject to the General Administrative Rules of the State of Indiana (S. ee 67SIAC 12) "regarding expiration\ \ \ \ \
'\ "\ \ \ '1'
time frames for beginning and completing construction. \ \ \ J J c L \1 \
I. the undersigned, agree that any construction, reconstruction, enlargement, relocanon, or alteration of a structure, or i4ic\~~ge m..~se.cf&nd.QOU \ \ \ _ ! i ~
structures requested by this application will comply WIth, and conform to, all applicable laws of the State of Indiana, an~ t~e \Zpnm~ce of Cannel \ \ J \
Indiana -1993" Z, 289) and amendments, adopted under authority of I C 36,7 et seq, General Assembly of the State of Indiana\ and all Acts amenAatory~ J\
thereto. I fu certify that only kitchen, bath, and floor drains are connected to the SanItary sewer I further certify th\~t\t~e ~nstructionWill n~t b
used or upi un' a tilicate of Occupancy has been issued by, he Depanment of Co,~u~ty Services, ~annt:I. Ind.ana.. d _ _--- -
, < ( I\- t:el1tt5'\ L-~~
re of Owner or Authorized Agent' ~/ Date
INSPECTIONS REQUIRED
Upper Footing Lower Footing U
~ Meter Base Site
# Charged Re-
Reviews
Reviewed/Approved: Dep!. 0 Community Services (Date)
S:PermIts/fOrms/ILP RESlDEmlAL
P ,R.LF,: Additional Fees
TOTAL: % ;Jl?oO I .
~ Il'1fJt;drkrjk ) i/15/qb
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