HomeMy WebLinkAbout06100093 Application
SUBDIVISION NAME:, \ \ \ ;. {
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ADDf~4S9fluCTlON:/-t.JJ2[j fl/\. v $1-~--\-
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NAME OF UTILllY EXCAVATION CONTRACTOR;'" PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT .'S (IF APPLICABL~):
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BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
SEWER UTlLfTY
PROVIDER:
City of Carmell Clay Township Permit #O!o/OOfCJ 3
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Str~ctures
NAME:
FAX:
PHONE:
FAX:
r:; 7 I. 0 5'(pC(
STATE:
.0.
4 ~IO'%
at{o ,0779
STREET ADDRESS:17
BUILDER'S EMAIL ADDRESS:
Sl
BE~ METHOD OF CONTAo/ /} "
," ~
NAME: .5
me,
STREET ADDRESS:
PHONE:
cm:
STATE:
ZIP:
LOT': ~
ZONING: .w 0
SQUARE
FOOTAGE:
-~-,...;..-
or WV?
ESTIMATED COST OF C
(EXCLUDING LAND VALUE)
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~VlVl'
AP PARCEL
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-A 2000- "
OCT ~ O.,l" ::'
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PLU NG CONTRACTOR:,', !,
dG)'I'-+ 0u..L
Plu ber's Indiana State License #:
rC( q {, 00 /~)B ,-
Which plumbing codes will be a~plletrtOtheoo;st;;cti~n;
~.Intemational Residential Code w IIndiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
TYPE OF CONSTR CTION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
NEW STRUCTURE
ROOM ADDITION(S)
PORCH ADDmON(S)
DECK ADDmON(S)
REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB ~ BASEMENT (WALKOUT:_V.KN )
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_VKN
_V >< N
Manufactured v
Trusses: _Y ~N
Sump Pump: KV_N
F S~lF="~~"T r:rFo'l 'd' l\~ I' d~ od I d/ hi rmi' aI'd nl if' 'hin' 180
or .....~~y~~u wo' amI Y ~>J.lilgS, a . l~rfN! e s, an or accessory structures, t s pe t IS v I 0 Y constructIon corrunences WIt
days.Q~ ~ e~ft.~eof ~ffi~~,.of the bU:ildhigp~ftlilt-:l~amust be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
struc~'P1frnut~~er~fB~<Ji:~~i~l2,~e.net:ll'A'diiiinistrative Rules of the St.ate of Indian~ (See 675 IAC 12) regarding expiration time frames for beginning and
I h ~ ' dO_~ ;'f\~n;1I11\\i1-Y SERV\C'f=.~S \ completmIgc~nstructll0n.. [ h 'h [I d
,t e u ,frSI~.e ....:Jgret_mat any consttuctton, Teconstr.PFfl.c argement, re ocatlon, or a teratlon 0 a structure, or any c ange m t e use 0 an or structures
request by'thls a?I?4cttiolf\.:YJU\:ofhP~':Yi(,q: aliGWJ.NM , "applicable laws of the State of India~a, and the "Zoning Ordinance of Cannel Indiana -1~93" (Z'
289) <@r~n{W{enl!if9.abpted'onQer a.ut amy of LC. 36'7 et seq, General Assembly of the State of IndIana, and all Acts amendatory thereto. I further cernfy that only
kirchen, bath, and float. m4~M"\ to the sanitary sewer. I further certify that the construction will not be used or occupied until a Cernncate of
Occupancyhas t . D artment of Community services,~~:;; L AhvrfSc / {}(:I (I / c> c",
Signature of ner or Autho . Agent Print Date
OFfICE USE ONLY: ******************************~~******.**************J***1~"'**O**********"'******
INSPECTIONS REQUIRED: Filing Fees. , .L~ Ti3
Gpper F~ r-Footing Under Slab Base Inspections: d' # c~:~~e:;s Re-
Rough In ~I - iie n_-:; CertofOccupancy: I :!I-~O
~ P.R.I.F.: _ Additional Fees
----- d.;l /, 7 c2 ,~o
, ~ IO-do'()
Date
"'-
Reviewed/ Ap Dept. of CommunitY Services
S:Permits/Fom1sjIlP RESIDENTIAL
(Date)