HomeMy WebLinkAbout06110013 Application
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City of Carmel/Clay Township Permit #: om I ((j)t'j
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: .
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BEST METHO~OF COr-lrAcr: OC,..
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PHONE: ~ '''',AX: <'a
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STREET ADDRESS:
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BUILDER'S EMAIL ADDRESS:
STREET ADDRESS:
o '{09
LOT #:
'7-f-L{;j
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ANI) D,Jo
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PHONE:
3n~
-~40
SECITON:
2-
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SQUARE
FOOTAGE:
{I z-o
ESTIMATED COST OF CONSTRumON:
(EXCLUDING LAND VALUE) 2-S' 000
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT "S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUcnON:
IB"'SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_Y_N
_Y_N
TYPE OF IMPROVEMENT:
o 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
(9""'ATTACHED GARAGE
o DEMOLmON
Manufactured
Trusses:
~_N
_Y_N
TAX MAP PARCEL #:
PLUMBING CONT
Which plumbing codes will be applied to the construction:
o International Residential Code wI Indiana Amendments
o Uniform Plumbing Code w/lndiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM _PIER
I9'SLAB 0 BASEMENT (WALKOUT:_Y_N )
For Single Family and T~ famjJy:t;iweIJirf~op.@~I;\~thnbaliJ. essory structures, this pennit is valid only if construction commences within 180
days of the date of isslilllch~ftliebtilding permit,androust becQmpl~m{:Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure permits are s6hjiW:t~6tJie~~rr31'~~sti~tii~etit,?f the St,ate of Indian~ (See 675 IAC 12) regarding expiration time frames for beginning and
ot ~td0 ~! ,d LOCal_ ~C?T!~pqgconstructlOn.
I, the undersigned, agree..tP;it ~CGnstruction;,~~qn~tr~~tiol,1', lnlrttg~~~ation, or alteration of a structure, or any change in the use of land or structures
requested by thIS applicatlJ~i'colnfPIY Mil{ 'i'rid confo~ t9\, allftPP'lica~~fPthe State of Indiana, and the "Zoning Ordinance of Cannel Indiana -1993" (Z-
289) and amendments, ~~ ~r@~hor:ity~Jf.ic/3&.-7' ,rleHl Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor'M'dins are connected to tp,f " ~fte.wer. I er certify that the construction will not be used or occupied until a Certificate of
:(3:)as ~he DepartmetlJ I Onunll~ty;t:;C ,Carmel, IA~~ ~ tt 1(1 3/10'
Signatu... of Owne. o. ,.thomed 'gent ' $:3 I ,int Da'" (
Sump Pump:
***************************************************************
-;2~1 90
~
/6? . 50
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OFFICE USE ONLY: ****************
Filing Fees:
Base Inspections:
INSPECTIONS REQUIRED:
~er Footing). Lower Footing~er~lab
~.MeterBase c:~
# Charged Re-
Reviews
Cert. of Occupancy:
Additional Fees
P,R,I.F.:
. "'-,....//./:TOTAL:
/ <~.><.-.~:.:7,<.01
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S;PermitsjForms!IlP RESIDENTIAL
Fee Received by:
Date