HomeMy WebLinkAbout06090106 Application
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City of Carmel/Clay Township Permit #: cr& CfJt () If) It
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
NAME:
PROPERTY
OWNER:
STREET ADDRESS:
).. 6
LOCATION
&. PROJECT
INFO:
LOT #:
SUBDIVISION N'\tlE:
00 J" .f
FAX:
.,;::)S -~ S" '1?
ZIP:
t./foJ...;).,
BEST METHOD OF CONTAG:
E - f,MCc ..
O~ MI{
FAX:
~ ~ - J.. :;-9 q
STATE: ZIP:
<ff:,).;),l)
SEcnON:
( :-ZO'~I!~G'
.J
SQUARE
FOOTAGE:
700
SEWER UllLTIY ^ (
PROVIOER: I...: ~
NAME OF UllLTIY EXCAVA ON co GOR; PLAN COMMISSION / BZA / B~;
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT #r.JI. -
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
'" ~i%'=~cted at this
RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_Y_N
_Y_N
TYPE OF IMPROVEMEN :
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
~ DECK ADDITION(S)
'-f'\ REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
\iY~
-AY _N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is valid only if construction commences wit~ 180
days of the date of issuance of the building pennit, 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 structure~
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the ~Zoning Ordinance of Carmel Indiana - 1993" (Z-
289) a d amendments, adopted und thority of LC. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify th~t only
kitch, and oar drains are on cted to the sanitary sewer. I further c ify that the construction will not be used or occupied until a Certificate of ,
Dee ey n issued by e epartment of Community Services, C el~I /' ana. 0 '. /J , 0. !
'Ci.~ , Ie tYt -L-;2./-6lf!7
Sig ature of Owner or Authorized Agent Prin Date I
I
OFFICE USE ONt Y: ******* ***********************~~******.****************I.***3**5*0****************
INSPECTIONS REQUIRED: FIling Fees. 3 . ~ :
Base Inspections: / I ( I # Charged Re-
Reviews
~ 3 . S'tJ
Sump Pump:
Upper Footing Lower Footing Under Slab
C"""Y 'M_'~ -;;0
lddL / .~ ~
ReViewed/Approved: Dept. of Community Services (Date)
S:Permits/Forms/ILP RESIDENTIAL
Which plumbing codes will be applied to the construction: ,
I
o International Residential Code w/Indiana Amendments
o Uniform Plumbing Code wi Indiana Amendments I
FOUNDATION TYPE: (Check all that apply for the new
construction area) I
o CRAWLSPACE POST & BEAM ~R
o SLAB ASEMENT(WALKOUT:-V~N)
Cert. of Occupancy:
Additional Fees
P.R.I.F.: .
dOTAL: ~JYrf. cfO .
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