HomeMy WebLinkAbout06100036 Application
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\c:;ityojCannel/Clay Township ~ permit#:Oh/(J()Oq?c
lliSIDENTIAL IMPROVEMENT LOC~ION PERMIT APPLICATION
,
"r Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
..."'ILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
SEWER UTILllY'
PROVIDER: U
NAM]
,
~
PHONE:
,3f7-'ttp./-o35
FAX:
fJ,/1-
ftt
CITY:
STATE: ZIP:
it.-o8'J.,.. ,
STREET ADDRESS:
,0'
BUILDER'S EMAIL ADDRESS:
-11M.
A/Zrtt /FI-
~
BEST METHOD OF CONTACT:
PHONE:
JI 0'to-3VJ{, OF" I
FAX:
,
AlL'aw..
cm:
ESTIMATED COST OF CONSTRUCTION: Al
(EXCLUDI~G. LAND VALUE) 75'7),000 f!!>'-
NAME:
s
NAME OF UTILllY EXCAVA ON CONTRACTOR; PLAN COMMISSION / BZA I BPW OOCKET -'"
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE): 1--f SHCL
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL #:
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
iii! SINGLE FAMILY
tJ' TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc. J
STREET ADDRESS:
lOT #:
SUBDIVISION NAME:
iJ OOPS
73
ADDRESS OF CONSTRUCTION:
I'
',(, t/~
c-L-'
TYPE OF IMPR E NT:
& NEW STRUCTURE
o 'ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_Y -.AN
__YLN
Manufactured V.
Trusses: _Y ~N
Sump Pump: --t:.- Y _N
PLUMBING CONTRACTOR
,
-" ..50^^
Plumber's Indiana State Li
OCT .:. 5 2006
Which plumbing codes will be applied to the construction: I
I
o International Residential Code w/Indiana Amendments
I
o Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the: new
construction area) I
o CRAWLSPACE 0 POST & _ BEAM ~PIER
o SlJ\B BASEMENT (WALKOUT:-X.-Y~N)
I
For Single Family and Two Family dwellings, additions, remodels, and/or acce&.'>ory structures, this penirit is valid only if construction commences wi~hin 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. qass I
structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginn~g and
completing construction. i
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or srructUl;es
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) and amendments, adopted under a hority of I.e. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bat nd floor drains are con ted to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Oceu eyh been i"ued by the artment of Community Se~" ?rm,' 'ndim.. . "'-:'\ -- .
- ~~ r-72 /i'1 iJA-w J / DfO P
~g ~' ~
OFFICE USE ONLY: *******************************.~*********************7*rY*~****************
INSPECTIONS REQUIRED: FIling Fees: /- -.Y ' - :
~ .~ ,..-- ;.:..= ~_ Base Inspections: ? :1? 00 # Charged Re-
llpper Footmv.u,ower FootinQ1S Under Slab) - ;3 .}o ReVIews
~....--.;;: Cert. of Occupancy: ,
~ (r,eterBase.--l:.. ~inal Site) 7 tJO
P,R.LF.: / 0<-
,
'----, /TOTAL:
,// /L/hfl>
I> ~tc~
(Date)
ReviewedjAppr v : Dept. of Community Services
S:Permits/Forms/IlP SIDENTIAL
Fee Received by:
I
Date
~