HomeMy WebLinkAbout06080135 Application
City of Carmel/Clay Township Permit #: (')lID~ 0 13,j
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
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BUILDER
OF
RECORD:
PROPERTY
OWNER:
BUILDER'S EMAIL ADDRESS:
W k C-uJ ..L
NAVOCA- K;;t{IJ /~
1./( Ie 'ZO"l ,
PH07Q q // 'I
FAX:
STATE:
ZIP:
BEST METHOD OF CONTACT:
LOCATION
& PROJECT
INFO:
STREET A'ORESS:i4 Ot<1
LOT #: 8U;;~bAMEL
ADDRESS OF CON~ON:
3/0 . I h.O><l1t5
ZIP:
()53
/
SQUARE If!:- /l a I'2f*
FOOTAGE: yL/ t!IP'
ESTIMATED COST OF CONSTRUCTlO.d1'2 9\0 0 ~
(EXCLUDING LAND VALUE) 9{ : u UJ
SEWER UTILITY /J WATER UTILITY1...., _ /J
PROVIDER: f(/l/)')11!/ PROVIDER: t/JU-.-f/
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); ANDIOR COUNTY WELL ANDIOR SEf'TlC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
'06 RESIDENTIAL (For
r Additions. Remodels. Etc.l
TYPE OF IMPROVEMENT:
NEW STRUCTURE
ROOM ADDITION(S)
PORCH ADDmON(S)
DECK ADDmON(S)
REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
o
fil.
o
o
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PROJECT INFORMATION:
Early Release ~ Manufactured
Permit: Y ~Trusses:
lot Split: _V _N Sump Pump:
V)( N
Y-V=N
'01 II'
TAX MAP PARCEL #:
i I r\\ I M~' I
PLUMBING CONTRACTOR: v VV :: U/
75 J l' J/ ~'L________________j lj
Plumber's Indian,4 State License #: 1
R /OmT07:;----- _________,i
Which plumbing codes will be applied to the constr-uction: I
I
o International Residential Code wI Indiana Amendn:aents
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
~ CRAWLSPACE 0 POST & BEAM _PIER
o SLAB 0 BASEMENT (WALKOUT:_V_N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pemtit is valid only if construction COJIUnences 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 c emrt-Q,.a1~pplicable laws of the State of Indiana, and the ~Zoning Ordinance of Cannel Indiana - 1993" (Z~
289) and amendments, adopted under authoritY. .c. 36~7 et seq, Gen I Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected the sanitary sewer. I furtli r certify that the construction will not be used or occupied until a Certificate of
PCCUPl';:as been '"u by the Dep ent ~ C. u~t~dervice', 'r7,ln:r' 1"15- g' /23 ~ 6
Signature of Owner or Authorized Agent rint Date
OFFICE USE ONt Y: ********* ***********~~******.*************";*****~********************
INSPECTIONS REQUIRED: FIling Fees. j/3 3. ""--0
~erFQotin0owerFooting lHIdbEsUlED Fo~acl:f~~1-~ErciT'ON /66.;>
_ U lee., lia6eftWlf~f\W~Dfa\ions <>-3 ' 50
CRough I~Meter Base mal SI~ State n~ bj;~I.Codes,
MMDKl/tY SERVICES
CITY OF CARMEL / CLAY JwmMiL-:
: Dept. of Community Services (Date) INDIANA f}J(.() / .iI'J
Fee Received b. .. ~
$:permltsfFormsf
# Charged Re-
Reviews
Additional Fees
~lS;50
. ,11 ,.,d
, Date
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