HomeMy WebLinkAbout06100088 Application
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City of Carmel/Clay Township ,"'~"" Please call 695-7630 for Permit #: 1')&1 0 6D~
RESIDENTIAL IMPROVE~ioc'(Tf~tERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
NAME:
b
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
PHONE:
CITY:
STATE:
IN
ZIP:
I
BEST METHOO OF CONTACT:
FAX:
STATE:
I
ZIP:
..,
7f
ZONING:
SQUARE
FOOTAGE:
,
a..!
SEWER lJT1LITY
PROVIDERC
NAME OF lJTI EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
'J NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE IJF CONSTRUCTION:
rYf SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
_y~
__v IN
Early Release
Permit:
Lot Split:
TYPE OF IMPROVEMENT:
~ 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
Manufactured
Trusses:
Sump pump:
~_N
-.Ly _N
TAX MAP PARCEL #:
PLUMBING CONTRACTOR:
~ f. SM'lTIl
Plumber's Indiana State License #:
101'177
Whi~umbing codes will be applied to the construction:
~ International Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPA<;Y 0 POST & BEAM PIER
o SLAB rY5 BASEMENT (WALKOUT:_Y A)
For Single Family and TWO._ I~, ~flp1pl1rem~cM~ffl<fry structures, this permit is valid only if construction commences within 180
days of the date of issuanli!,qfJ e 1.V. dmg.e..e,!!P.iJ, ana fil'~~'Belcoh\Pld:ed ,~~:i'tificate of Occupancy issued) within 18 months of the issuance da~e. Class I
structure permits are subje"r!'t'1:~ P ;e<j\&MIAli:fflii\B~tWet:rouft.!.l6~eJStiatEl6t:Jndiana (See 675 lAC 12) regarding expiration time frames for begmning and
of State and Local Coci:ell'pleting construction.
I, the undersigned, agree th~~ism"~~9rnJilPfR.fP~~fDlCf\t1F~p;:if>n, or alteration of a structure, or any change in the use of land or structures
requested by this appllcati~"'WIlI comPlY {."itlr,' ~tldl~~fmm t6, lal! apptteabf'e lk~he State of Indiana, and the "Zoning Ordinance of Cannel Indiana - 1993" (Z'
2~9) and amendments, ad~~JdhcGJrutQWJ.W1Q~1~.t16f7@~eA.:'Y5eifqf1~N~rphe State of lndi~na, a~d all Acts amendatory t~ereto. ! further ,certify that only
kitchen, bath, and floor drams are connected to thM,\l4flW KT~r\1 fUrther certify tHat the constructlon WlIl not be used or occupIed untd a Certificate of
o cupancy has been issued by the Department bf'tYhh\blMt)! Services, Cannel, Indiana.
. .' -' LOR" A. e;,Rh':.ONG- HE:MI;"lI: 101 IIID~)
Signature of Owner or Authorized A Print Date
OFFICEUSEONLY:*********************************************************************************
INSPECTIONS REQUIRED: Filing Fees: / orfl. r2~
F' t' Base Inspections: "OJ/ -1'1. ,5 ()
ower 00 In Under Slab S 0
=stte) Cert, of Occupancy: 3 .J_
/ P.R.I.F,: /J U 00
\ O-\l-~ ~.. . J9lAL: ~ I;)G~~:;~I_ "fJ
Dept. of Community Services (Date) ~~ -.fl1 ~ __ _ _ u~
S;J'ermits/FormsjILP RESIDENTIAL Fee Receive by, Date
~
# Charged Re-
Reviews
Addibonal Fees