HomeMy WebLinkAbout06100206 Application
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
SEWER lJTIlfTY
PROVIDER:
City of Carmel/Clay Township Permit #{)01 00.201.0
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
NAME:
STATE: ZIP:
/ .u J( r.. :1..'f(
CONTACT: l:sc ,
W'
FAX:
5/7 81..1
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(J f.-I~MEf
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STREET ADDRESS:
--71(0 0 I!"C 'U' V It
BUILDER'S EMAIl ADDRESS:
-r ':;Il!t..{)g~ (( e, Ke>N
NAME:
AI .oNt. ~5'./\
.-'BEsT~M€rnOD\O
. C-6 ~:;;::,f1 \?:i\~ ' ,
,.---<,=(' '''PHONe}' ~
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\\\ \, CITY: \ (,;'
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SUBDIVISION NAME: \'\
e-4:; ttsYl/rl!f
ZONING:
SQUARE loll l.J7
FOOTAGE:~I r..,.,
FAX:
SJlfI1E
STREET ADDRESS:
ZIP:
LOT #:
13
ADDRESS OF CONSTRUCTION:
3 'f'?9'
ot1.
C-Tf}.wb
~7o I"i.
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
WATER UTILITY
PROVlOER: c-111t "'de-
NAME OF UTILITY EXCAVATION CONTRACTOR; PlAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC OAlE(S); ANDjORCOUNlY WELL AND/OR SEPTIC PERMIT #'S (IF APPllCABLE): Po I r.J I) t?)C f"t It. :JI: Ob lOO:::Z oS
TAX MAP PARCEL #:
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERlY:
""
. II 1
TYPE CONST . : . p.I.' TYP..E.9.fn;u.'lIl'''''''IIitIMI':
u lec , com ~. ,. "'9' 1
SINGLE FA LY of S. tale, ancW5tNEWsft'f9crURE
o TOWN HOME ".F OQM~__"lOlii
o TWO FA. MILj)~PT. Q I. 1'.
# of.uniPiAetnli"lF eAF1M~ A '
construd"edat ffi,s 1',>\ ,'0' 'R~ODEL
time: I L.J1r\1~ Basement Finish only
o RESIDENTIAL (For 0 ACCESSORY BUILDING
Additions. Remodels. Etc.) 0 DETACHED GARAGE
o AlTACHED GARAGE
o DEMOLITION
PLUMBING CONTRACTQ&. dJ
!W' r.1 aM>- .s].~e..il'}_ ,q:.&n'AA L
lumber's Indiana Stat 'oice"'-'i' I , .,
, 8'ff g "j ...~ ., ')=' 13- ..
Whi~lumbing codes will be applied to the construction:
0" International Residential Code wI Indiana Amendments
o Uniform Plumbing Code wjlndiana Amendments
'.'J
Manufactured
Trusses:
Sump Pump:
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB ~ASEMENT (WALKOlJT:_Y ..... N )
Early Release
Permit:
PROJECT INFORMATION:
Y~
-\7.
_Y_N
A_N
V"'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 Cannel Indiana - 1993" (Z'
289) and amendments, adopted under authOrity of J.e. 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 or occupied until a Certificate of
Occupa.ncy has n issued b the Department of Comm nity Services, Cannel, Indiana.
~~ 11-~
Lot Split:
So 4"
k c ~ (J(/L.ri'''(A'~A,)rJl/)/3IJ /,
Date
,
OFFICEUSEONLY:******************************~~******~****************f~~*~O**************~****
/'INSflECTIONS-REQUIRED: Filing Fees. ,/O!..:. if :
/ B I ct 7J? ./ # Charged Re-
ppper_F~ti Lower.~ooting Under Slab ase nspe ions: ,; 3 :;0 Reviews
~---) Celt, of Occupancy: . )
eter Base Fi Site . I' I II 0 Additional Fees
P.R,I.F.. _ . ( (., .' L'
.. TOTJ}~: v Jidi 05.
~ Review jApproved; Dept. of (Date) ~1' a 711edrill1 ~J;r;. )
l. s\"nn'''/Fom'';'ILP RESIDEtmAL Fee Received b 0
70
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I (Jate