HomeMy WebLinkAbout06090109 Application
City ofCarme/lClay Township Permit #: Oft 09 () I D9
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:
NAME:
STREET ADDRESS:
/~ ?
LOT #:
__._PHONE> FAX:
~,\/I\2~\'-::J /-C;Ytb-O i)~
..,1.~ ' r
'" .~
..--dTY: \
/pl .
., IV t'l
,.. SEI' 2 I 200 U BESTMETHO OF
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SUBDIVISION NAME:
ADDRESS OF CONSTRUcrrON:
5gtJ og,7.:2_
PHONE:
?}5-~
FAX:
- 0 ljp.:t.
ZIP:
Lff,t/ 77
CITY:
Z:
SECTION:
ZONING:
SQUARE
FOOTAGE: C 0 ~
ESTlMATED COST OF CONSTRUcrrON:
(EXCLUDING LAND VALUE) I 5'0 00 tJ
SEWER lITIUTY WATER UTll11Y () d
PROVIDER: PROVIDER: lAJ ~ .
NAME OF UTIlITY EXCA nON CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); ANDIOR COUNTY WELL ANDIOR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S) Ifl J Jl
FOR THIS PROPERTY: 1/ 1/ rT
TYPE OF CONSTRUCTION:
lIJ!l SINGLE FAMILY
fV{J' TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
~ RESIDENTIAL (For
~ Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
_Y_N
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 DEMOLITION
o
o
:g
o
Manufactured
Trusses:
TAX MAP PARCEL #:
PLUMBING CON~R: ~
\-)dv. ( J? f 117/
Plumber's Indiana State Lm"
pc 19700~'I:<.
\. ~ plumbing codes will be applied to the construction:
~tematiOnal Residential Code w/Indiana Amendments
o Unifonn Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST &. BEAM PIER
~B ~SEMENT (WALKOUT:_Y N)
Sump pump:
I
For Single Family and ~~\1X,Q.~l~l,ip,~I~~,~tNrn.QFl~Sessory structures, this pennit is valid only if construction commences within 180
days of the date of iss iet.l~~~~~ltti.Hs: ~-mut..~~ ~?~Anf.Ompleted (Certificate of Occupancy issued) within 18 months of the issuance date. Cla.ss I
structure pennits are subject to tl\JGeh1:Hrl AHf;U.hUif~tiv'e'ltlii.~~..Rf W~ of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
nl=pT OF COMMUNITY SEI&Jidj\ItHrigoon'truotion.
I. the undersigned, agree 'rf1~ anx con~~~~I:l~p:~onjilf\lttil\.~m~~~tPon, or alteration of a structure, or any change in the use of land or structures
requested by this appli<@p~lU6n~hYhi\d-edn~, all 'applicabrelaws of the State of IndIana, and the "Zoning Ordinance of Cannel Indiana -1993" (Z~
289) and amendments, adopted under authorit)! PArn.P<N:A seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to th~ sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Oocu been issue y the Department 01 Community Service" U:d~m~ C a/'/7 VI j l;7 s.:o.'..U? ;( / tJ b
51 of Owner or Authorized Agent Print /" T
Lot Split:
_Y_N
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