HomeMy WebLinkAbout06100069 Application
City of Carmel/Clay Township ~f\~'>Ol1lb'Ut'>~ Permit#: Ofti/O ooro1
RESIDENTIAL IMPROVEMENT LOeATION 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:
OJ ~~ I,Nc
rij/a'll CorrJer( a( j,
PHONE:
~- 7 J-[>o 00
FAX'
r;1;1-gor!J
STATE:
~;v
ZIP:
{5 tlJL
cm:
Car
NAME:
STREET ADDRESS:
BEST METHOD OF CONTACT:
L <::"0 "^
00
PHONE:
FAX:
c::
cm:
STATE:
ZIP:
LOT #:
PROJECT INFORMATION:
SEWER UTILITY --/J WATER UTILITY ESTIMATED COST OF CONSTRUcrrON;
PROVIDER: C Ti<- tli PROVIDER: GJ /:::.~ (EXCLUDING LAND VALUE) '()(}
/ .. \ " ::.....
NAME OF LmLnY EXCAVATION CONTRACTOR; PLAN CDMMISSION I BZA I BPW D9~ET, ,\" ~
NUMBERS; TAC DATE(S); AND/OR (DUNn WELL AND/OR SEPTIC PERMIT #'5 (Jp'~rptt-C?ABCE): :--.
/".\ :/ "",^,
FLDOD ZONE AREA DESIGNATION(S) -:;i ~ / ''\~ \ \
FOR THIS PROPERTY: ~ ~;?7 ~ W
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
i8:.. TOWN HOME
"0 Two FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.l
Early Release
Permit:
Lot Split:
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_Y4-N
ZONIN ' t.(.6
SQUARE /'7
FOOTAGE: pi..
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SECTION:
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rPki'
o
o
o
o
Manufactured
Trusses:
Sump Pump:
4Y_N
_Y-.r'N
o CRAWLSPACE
o POST & _ BEAM _PIER
SLAB 0 BASEMENT (WALKOUT:_Y_N)
For Single Family and Two Family dwellings, additions, remodels. and/or accessory structures, this permit is valid only if construction commences within 180
days of the date of issuance of the building permit, 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 structures
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 a nts, ted under authority of LC 36~7 et eq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, a flo ins are conn d e sanitaLY. er. I further certify that the construction will not be used or occupied until a Certificate of
Occupancy, bee uedbyt tofCo l2;z;;~ 7:>cl/i~ ~--9--(}{
Sig . print! Date
OFFICEUSEONLY:*********************************************************************************
SPECTIONS REQUIR . Filing Fees: b {; 2. '8 G
Base Inspections: c:::z -; l- :)0'
'-3, -;'0
Cert. of Occupancy: "'" '
P.R.I.F.: / c2 (, / eJO Additional Fees
tu TOTAL; ;#,;2,;U/O gO' ,
';;_::'&, tJ 1AMdrr' li/!J#
# Charged Re-
Reviews
Reviewed/Approved: Dept. of Communi 'Services
S:Permits/Forms!IlP RESIDENTIAL
(Date)