HomeMy WebLinkAbout06090064 Application
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City of Carmel/Clay Township Permit #: ~Dq()f)(P~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
SEWER UTILITY.
PROVIDER:
NAME:
FAX:
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NAME OF UTILIlY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
. e-',
TYPE OF IMPROVEMENT:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWOFAMILY
# of units being
/ constructed at this
time:
RESIDENTIAL (For
Additions. Remodels. Etc.)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
~Wl5PACE 0 POST & ~_BEAi!I:::;--~~
_____._:=:; n ~H \~ \ \\
SLAB O,..-BASEMENl'('(WAEK0UJ: '\J . I
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For Single Famil . d .'. e s, r accessory structures, this permit is vali4'~nl~,\,\ .:cons~ion conunences wi ~\
days of the dateSU9f9ntdof~~mii:tt1aJ1a ~tiltODlJ:*ted (Certificate of Occupancy issued) wi~J~ onths of the issuan~e. C I
structure permits are subjeef'5~~~~O'tHrs~uIes of the St.ate of lndian~ (See 675 IAC 12) regardi~ tp';" tion~fr:i\ne$fot.~in
,...f~Ietmg construction. \ \ ~ \l[:.'
I, the UnderSignedQ~. thaOrij ~~J;QhSiEiiRMltgdiia.t, relocation, or alteration of a structure, or any' f a in the use of land res
requested by thi~ . . i9tooJ)'I~' h, J1d FOA~,H.MR~daws of the State of Indiana, and the "ZoningO di ce n iana 1993" (Z'
289) and amendJr'eh1s, ~d ed rid'~r';:\H 0 I o'ri.'C 3fk h~q,teb)!t~l'A~sembly of the State of Indiana, and all Acts a endatoty thereto. I further cere" y
It en, bath, and fl rains a cannel ANAitary sewer. I further certify that the construction will not be use or occupied u . Ocate of
Dee 'Paneyh en ""med b th Dep~ment 01 Conunumty Semee" C4;dl~ '4< ob I'f-iln
Print J
Early Release
Permit:
PROJECT INFORMATION:
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Lot Split:
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
~CCESSORY BUILDING
DETACHED GARAGE
ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
x..y N
_yb
Sump Pump:
PLUMBING CONTRACTOR:
Plumber's Indiana Sta'QJ~
Which plumbing codes will be applied to the construction:
o International Residential Code wI Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
******************************~~****************************~******************
CTIONS REQUIRED' V "'/llIng Fees: :::s ?- 9 ' q
pper Footing Lower Footing U~der Slab q \ P Base Inspections: / (e r.a ' \--) 0 # C~:~~ee;;s Re-
~ ~ Cert, of Occupancy: 5-=3, ~f)
Rough In Meter Base FI-nal. Site .
C. - P.R.I.F.: ~ 5 t{Cf, :iiDft Fees
9 it tJ/p
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Reviewed/Appro Dept. of Community Services
S:PermitsjFormS/llP RESIDENTIAL