HomeMy WebLinkAbout06110033 Application
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I:ity of Carmel/Clay Township Permit #: &lRlI 00 3 3
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RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Tw6 F';inij}.,"New Structures, Additions, Remodels, &. Accessory StrJctures
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: ,.",// "- -'-. PHONE
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C .... ASS \ C. I-k:>m.'.€'..s I \"Ie.. '-t~l
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STREET ADDRESS., i !', /lOV . STATE
:>S<oS Cofl.S.l-tA-""/C"t,c..U:: - I'~eu '^'
BUILDER'S EMAIL ADDRESS ( -''''''~'---.. .....V"/jO ,BEST ME-hmD OF CONTACT:
~. ~.--_______ ce.4L,<j!C~';~9+1o-5Sb4-
--......................... PHO~ FAX
Ho'r'l'\es)r.c. c3"7 '!73- 99"2! 31V 871-c'4l" i)
NAME
~ER of
,ORD:
PROPERTY
OWNER:
NAME
e-l-....,Ss 1 c.
STREET ADDRESS
-;SE:,lJ C6l2.S:~dl CIfU:-L6
SUBDIVISION NAME
G:> f I "'- ~ dr '10Ul,..'lB Po ,I-l~
ADDRESS OF CONSTRUCTION
.:lAP(; P~Q5jt:k'nf- 9h-ut- c~g....1 IIJ 4/:,632-
WATER UTILITY 0 Ip i 6?J 'J-
PROVIDER: e;\..
LOCATION
&. PROJECT
INFO:
lOT #
SEWER UTILITY
PROVIDER: c..;'F~t<. 1)
FAX
01'7 273-&4100
ZIP
-4,"032..
ZIP
4bo~'2.
cm
~et..
SECTION
ZONING:
gl
SQUARE
FOOTAGE: 78 '-3
ESTIMATED COST OF CQNSTRUcnON:
(EXCLUDING LAND VALUE) 4;ts,oc:> 1:)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET C ~ I r')
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):!,!:> e,l::- -c:.,.C~ V c..c-K ~~ . Q:)-oq. 0 ..J"':>
lot Split:
Does any part of the Ifte
For Single Family and T ~ "~llimlUPWl~lQ~~flJ.w:essory structures, this permit is valid only if construction commences
within 180 days of the; date of isstOftit~lll.1.f:fU- a mustb~"'completcd (Certificate of Occupancy issued) within 18 months ofthe
issuance date. Class I 8rnt\EFr'OF " "Ift.Si t IKI , 'lidJpll1~~ative Ru~es of the Stat~ of Indiana (See 675 lAC 12) regarding expiration
IK~, A HV~~ompletmgconstructlon.
I, the undersigned, agre~~s~n/tftltiA\lef'Jtfi'lMJMa:RTrJtion, or alteration of a structure, or any change in the use of land or
structures requested by this applicatic.:!.~ will cOIW2hr.....1A~;Qci lonio"fM {d,lh'l~~able laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993" (Z~ 289) and amendments:'11dop~m~ority of l.c. 36~7 er sect 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 notibe
used or occupied until a Certificate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana. .
~ f. f.JzA
Signature of Owner or Authorized Agent
TYPE OF CONSTRUCTION:
00 SINGLE FAMILY
ti TOWN HOME
o TWO FAMILY
# of units;
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Y VN
-Y \h
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o AlTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
_Y ~
..?-Y _N
PLUMBING CONTRACTOR:
J+oO~Ilerl2.. l/LPo-!)E' pLi.>""~l~
Plumber's Indiana State license #:
----P n~ 'is-,"o 2-
Which plumbing codes will be applied to the construction: '
o International Residential Code wI Indiana Amendm1ents
~ Uniform Plumbing Code wi Indiana Amendments I
(Multi-Family Construction Code)
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FOUNDATION TYPE: (Check all that apply for the new
construction area)
Sump Pump:
VIL-,{'
Print
o CRAWLSPACE
o SLAB
tion area: _Y VN
9 .lOST & BEAM
L\Y' ~ASEMENT .
WALKOUT: /Y~N
f'. 1JvrE:<L.
''1. $:'/0'"
D .
OFFICE USE ONLY: ** **************************** ************* ****'*-*,r*tt:y..*~*****************
Filing Fees; 1/ /5 < :3 (J
INSPECTIONS REQUIRED: ~ ) 3. A/', # Charged Re-
Base Inspections: 2.. 0 . i/U
ower Fo r:.S,la 7 , /-' ReViews
Cert of Occupancy: ~~ :J, j 0
P.R,LF,: / c2 & I ;J rJ Additional Fees
,,'-?< /}~!Al://7 jI c/? cJrJ.;, gll
,cJ/a?;;{j/(::>-j:> 1/"
Fee Received by:
Final Site
lL-I
unity Services (Date)
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