HomeMy WebLinkAbout06100060 Application
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City of Carmel/Clay Township Permit #:~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
NAME:
STREET ADDRESS:
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PROPERTY
OWNER:
NAME:
STREET ADDRESS:
LOCATION
&. PROJECT
INFO:
LOT #: 1. :)' SUBOIVlSIOCZ:
ADDRESS OF CONSTRUCTION:
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SEWER umLITY
PROVIDER:
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PHONE:
FAX:
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CITY:
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STATE:
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BEST METHOD O~NTACT:
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PHONE:
FAX:
CITY:
STATE:
ZIP:
SECTION: .3
ZONING: ;;
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FOOTAGE: r')L
NAME OF umLITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET L
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT #'S (IF APPllCABLE): / ( - I
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Manufactured
Trusses:
Sump Pump:
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TAX MAP PARCEL #:
PLUMBING CONTRACTOR:
EC-<A/ (f:rt-l ~
Plumber's Indiana State Li.,(;nse #:
/0>909'
Which plumbing codes will be applied to the construction:
G::J...intemational Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
~WLSPACE 0 PCST & BEAM PIER
D---SLt>.B ~MENT (WALKOUT:_Y --N)
For Single Family anc!..T~.'!. ~~i~L dwellit;Qs, additions, ,remode~ and/or accessory structures, this permit is valid only if construction commences within 180
days of the dcfEti!ti~ @~iflili)NS~trHld~pleted (Certificate of Occupancy issued) within 18 months of the issuance date. Class 1
struet",e pe"millial!I"iS'\:f8lilpfial'fC~ MI1'i'liI~~~!;the Stat< of Indiana (See 67S lAC 12) regarding expiration time frames for beginning and
UJ completmg construction.
I, the undersigned, agree t~t ~-P~~fMJu~dogS~o~EtRm, e~2~ent, relocation, or alteration of a structure, or any change in the use of larid. or structures
requested by thif)~i@ Fil{)~~NiCf<Vn@rn.~Vl~wn.Q:gable laws of the State of Indiana, and the ~Zoning Ordinance of Carmel Indiana - 1993~ (Z-
289) and amendiiients,.*I9Pt~ 1Jiid.~r jJJJ:p-orj~f I,h ,36t7rf".!jffh. ~I::t.ssembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath,GHlrr{or..&Wn~tiM~It~Jital#~F""'t-lftr\.tler certify that the construction will not be used or occupied until a Certificate of
Occupancy has been issuef b~ ~ffJ?f.. Community Services, Cannel, Indiana.
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iigpllture of OWner or Authorized Agent / Print Date
,
,
t:'ICE USE ONLY: ******************************************************
Filing Fees:
INSPECTIONS REQUIRED:
'''~cower Ri~' Under Slab
'~~MeterBa~in~ ~
Base Inspections:
Cert, of Occupancy:
# Charged Re-
Reviews
P.R.I.F.:
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Dept. of Community Services
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Additional Fees
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