HomeMy WebLinkAbout06100109 Application
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CityofCarm~Tlcia~-;ownship c~'> Permit#: D&/ DOW't
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, MUlti-F~1\t:iiI'l8.I,Y: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of NAME Shannon Hinshaw PHONE FAX
RECORD:
\
STREET ADDRE
CITY
STATE
ZIP
. Indiana lis, IN 46250
BUILD4l'tlOAei~R1>606-2941 Fax 317-842-3389 BEST METHOD OF CONTACT:
".
PROPERTY
OWNER:
NAME
FAX
STREET ADDRESS
LOCATION
& PROJECT
INFO:
SEWER lfTILITY /7 11 I, Y"\~ A A
PROVIDER: LU./U r LtA.
PHONE
CITY
STATE
ZIP
ZONING:
TYPE OF IMPROVEMENT:
~ NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
It'
AI v"/ eaJz mLi 11\1. 4.
WATER UTILITY 17/1 ), /V'1 J! ,
PROVIDER: LLUU / l-{/L-
ESTIMATED COST OF CONSTR
(EXCLUDING LAND VALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
Manufactured FOUNDATION TYPE: (Check all that apply for the new
_X Y _N construction area),
Trusses:
Sump Pump: _Y LN S ~~:LSPACE\,':r B' ~~~M&E~~M "
Does any part of the property ie within a special Flood designation ;:;ea: _Y Xi ':r-!\ \ WALKOIJT;~Y----,---,-N
". ,.. ,.... 1 f) j,,,,,,", ".
For Single Fa~wOiI:"lI9tOTi~mIW1!ftllb~fn9;-fe_~qsl jJl4/or accessory structures, this p~,#i~ \~ vali o~ly if~o~st;;;c~ion commences
within 180 daysA.iJ;'E.e date orizsuance o(th~-r)1~i1~lli'g'Perltiit, bhfi ITrttst be completed (Certificate ofpccuPflncyissued) wi!hi~_le}}lonths ofthe
issuance date. cl~~hlallseJnh~MQ..Mij'roQ,tht\QerlmlOOministrative Rules of the State of Jndian.f(SEe 675 lAC 12) regarding expira~ion
. 'Sa'pOQIB:JOl P9U1~f~p.:forbeginningandco~pletingcon~truction. \ ,__"__'''.'_'<.'~'_ .. ..._~_,
I, the underSlgnedmtllY-y ftWlEf:fiW!tl98-t. ~11<(m5~t~?Pl5wW&tE1.lent, relocatIon, or alteratIOn of a structure;"orany cliange In the use of land?r
st~ctures req~esteQ. p~'s VI1~t~rf'i\?l),,,orp:p!y' vr~li,Jll}.i;f\c2nt6"nn'RJ, all applicable laws of the State of Indiana, and t~e "Zoning Ordinance of Carmel
Indiana -1993 (Z~:!)f~ :~N~!etWiill&..<1UthOlitFdtEl::f. 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 are connected to the sanitary sewer. I further certify that the construction will not be
used r occupied uiuil a rtlficace of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
\fll/l;./JJOV IiDJJI-I/JW /O-/([)dl&
TYPE OF CONSTRUCTION:
-9-- SINGLE FAMILY
~ TOWN HOME
o TWO FAMILY
# of units:
tift MULTI-FAMId!LY
11'" # of Units:
o RESIDENTIAL or
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_ylN
_y-LN
Plu er's Indi na State License #:
/tJdOOOS7
Which plumbing codes will be applied to the construction:
~ International Residential Code wI Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
OFFICE USE ONLY: ******************************************************~~****************
Filing Fees: tR 4?- ::3, KtJ
INSPECTIONS REQUIRED: . n ry r-t Ir 0
- Base Inspections: ~ + I. V-.
____ Cert. of Occupancy: 53. Kf)
Site C"'"77. f} 0
P.R.I.F.: ~~_
j~
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