HomeMy WebLinkAbout06100089 Application
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City of Carmell Clay Township Permit ~ I to D81
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:
SEWER UTILITY
PROVIDER:
NAME: D ~ c..,( I,J c!>R.K:s II\lc..
STREET ADDRESS:
101.(7(0 t"1 fl..5'/.
BUILDER'S EMAIL ADDRESS:
A~!)y' € DEl,
/10(,. c.o
PHONE:117 S'fO 739&
FAX.
. 8l3- &J~Zc(
NAME:
-rOr-A
KRV2.1
CITY:
STATE:
lIP:
STREET ADDRESS:
C-,.
IJS6Mo.,)O
BEST METHOD OF CONTACT:
PHONE:
FAX:
LOT #:
1./
SUBDIVISION NAME:
SQUARE ~
FOOTAGE: J ~ z..
ADDRESS OF CONSTRUCTION:
CITY:
ZIP:
STATE:
WATER lJT1LfTY
PROVIDER:
ESTIMATED COST OF."CO~5i:R'UcTI6N.:i:.~:i.ii--~\-7;--:'~;_::":::_~' ,1
(EXCLUDING LAND V~UIE? Jr;.~~ <~ -:,' /::.//~!t~rY\ ~
unShttded
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITION(S)
~ PORCH ADl?mON(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
" Ii
i i,\\ ,I
1'1 "
TAX MAP PARCEL #! i
iU Ui
I I
,
PLUMBING CONTRACTOR:
N A
Plumber's Indiana State License #:
i I 'II
il Iii
II .
I' !
1'-=/
/
NAME OF UTIl1lY EX V ON C CTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DA , AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
TYPE OF CONSTRU
JK( SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INfORMATION:
- ,..'-
For Sin e ;unllY t;Q ~.f.mWJr:qwJ!H~~l:a~!~t9m>l~fl?9dels, and/or accessory structures, this pennit is valid only if construction commences within 180
days rn..~ op.~p~~ ",o!~Jie 'bup.a1I)g p~t: and ~ust be completed (Certifi~ate of Occupancy issued) wi.thin 18 ~o~ths .of the issuance da~e. ~lass I
structure penrutsG.h&ta;~t.totthbG~cltl'AHnillllstrat1ve Rules of the State of Indiana (See 675 lAC 12) regardmg eXpiratIOn tIme frames for begmmng and
~T OF r.OMMUNITY SERViCES completingconmuction.
I, the unMhi ;!;.~a&.ee1Ji~t :m',col}s~ctAQ..r;. rec;oWl~W51~MJ!hlrgement, relocation, or alteration of a structure, or any change in the use of land or structures
reque.<G:l h~pijpA~rbPo/ Wfthl anIcM~tbh'i1"t'd, ,Ufapplicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana - 1993" (Z,
289) and amendments, adoptef~A1Kt1D.J:ity of I.C. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains alJ t6h'ne~t~d to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupancy has been issued by the Depanment of Community Services, Cannel, Indiana.
~hA - ANA,... Vt::T"-
Signature of Owner or thorized Agent Print
OFFICE USE ONLY: ************************lfC*************************************
INSPECTIONS REQUIRED: Filing Fees: 3 '7
Base Inspections: / t. h. ()
. ~~3. sO
Early Release
Permit:
Lot Split:
_YLN
_VKN
Manufactured
Trusses: _Y ~N
_VXN
Lower Footing Under Slab
Meter Base .~
J
Which plumbing codes will be applied to the construction:
o International Residential Code w/Indiana Amendments
o Uniform Plumbing Code w/lndiana Amendments
fOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE J>t' POST & _ BEAM bIER
o SLAB 0 BASEMENT (WALKOUT:_V_N )
1(:>/lIkl.
Date ~
*****************
# Charged Re.
Reviews
Cert. of Occupancy:
P.R.I.F.: 4 Additional Fees
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