HomeMy WebLinkAbout06090047 Application
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City of Carmel/Clay Township Permit #:~1
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Stru~ures
BUILDER
OF
RECORD:
NAME:
L
STREET ADDRESS'
PROPERTY
OWNER:
BUILDER'S EMAIL ADDRESS:
1001> , M 8182. Q
NAME:
I>.N~
STREET ADDRESS:
\3455
<<l
ST
LOCATION
&. PROJECT
INFO:
lOT#:
SUBDIVISION NAME:
,L.J..I\l;", of
C\o
SEWER UTIlITY
PROVIDER:
NAME OF UTIlITY EXCAVATION CONTRAcrOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); ANDIOR COUNTY WELL ANDIOR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
o SINGLE FAMILY 0 NEW STRUCTURE
o TOWN HOME BROOM AODITION(S)
o TWO FAMILY 6cf1P1N' 9'l PORCH ADDmON(S)
# of units being ,,) 'Ole 0 DECK ADDITION(S)
constructed at this . 0 REMODEL
time: _ Basement Finish only
\7'\' RESIDENTIAL (For 0 ACCESSORY BUILDING
l\ Additions, Remodels, Etc,) 0 DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
PROJECT INFORMATION:
_Y J1 N
_Y ->>
Manufactured
Trusses:
Sump Pump:
_Y~N
_y)s2.N
Early Release
Permit:
Lot Split:
PHONE:
'7[7.
FAX:
317, 5""t9, 1~71
CITY:
F~
STATE: ZIP:
tJ
PHONE:
3l>3-, ISSO
CITY,
CA1l...IY\'i-t.
FAX:
STATE,
N
lIP;
4/,.032-
SECT10N:
007
ZONING:
SQUARE -l: '3 Ceo
FOOTAGE:
ESTIMATED COST OF CONSTRUCTl~'
(EXCLUDING LAND VALUE) if 5' Il 00,-
TAX MAP PARCEL #:
...".-
_.~---;~;:f7fi~~\f>,~:'
PLUMBING CONTRACT<?R:-\~ (<0 \~~.'-.--- \\\ \~\
~ \\\'\ ~.~ \\\ \
l\\ \\r ~ \\\ 1
; s Indiana State Li~~~~\: St.? , '\ 1\N ~\.v
Wh' h I b' d ' ""Ied\" h ~---
Ie p um mg co es Will be app ~ t e CXUl5tru\;uon:
\W ~
o International Residential Code wI Indiana Amendments
o Uniform Plumbing Code whndiana-~ents
FOUNDATION TYPE: (Check all that apply for the new
construction area) ~
o CRAWLSPACE M POST&._BEAM_PIER
o SLAB 0 BASEMENT (WALKOUT:_Y_N )
For Single Famiw ,~d J)Xo aml.lY..~"Y~llih~, a .(1 iibn , ~, or accessory structures, this pennit is valid only if construction commences within ISO
days of the datiM'iJSiliLh!PJfHielJhilita~. <tri, ~~!atl3afi4tleted (Certificate of Occupancy issued) within 16 months of the issuance date. Class I
structure pennits are subjai titate<Gttlt:t e.~.Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
I, the undersi~. ~J~JhQ~itoQ~~MJJ,~!~~~YJlg~~~~~~!c~~~~~c~~~~tion of a structure, or any change in the use of land or structures
requested by t~lpplka::i)J!i 'I\,::jlA~Eflt~, ~o~ laws of the State of Indiana, and the ~Zoning Ordinance of Cannel Indiana - 1993" (Z~
289) and amendments, adopted under ~~t~irx RI,I,+:. 36~7 ets~q:GeneriIAssembly of the State of Indiana, and all Acts amendatory thereto. I further certify that onLy
kitchen, bath, and floor drains are conrM:'iM ~Otb~~nitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupancyhas been iss ed by the Department of Community Services, Cannel, Indiana.
41lcJ ~YM f I /. lit;
Signature of Au orized Agent Print Date
.*********************************************************************************
. e Filing Fees: I 7&/ '7 DO
INSPECTIONS REQUIRED: I
~p~r FO~ Lower Footing Under Slab q I 'fBase Inspections: / fa~ . S; 0
~ Celt, of Occupancy: ~ '5, ..5-0
(iRou!ihIn> Meter Ba,se Inal Site
. -"'" "~ 4OTAL' tf "II.. f;"~'-
JlfP--#t~CL ~
Fee Received by: .
Reviewed/Approve Dept. of Community Services
S:PermitsjFOfmsjILP RES! ENTIAL
# Charged Re-
Reviews
Date