HomeMy WebLinkAbout06110031 Application
City of Carmel/Clay Township Permit #: I)(P 111)1) 6)
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
CITY: STATE:
G.r11A
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For Single Family and Tf!!i~~W A'f"t:J4ngsl4:~i~!lh.r~m-pdels, andlor accessory structures, this pennit is valid only if construction commences within 180
days of the date of iss~-litJU{nf:PJdi'li~rJbablQiJ"~ertificate of Occupancy issued) within 18 months of the issuance date. dass I
structure pennits are s~~~&PhE;8f ~f6tisof Indian~ (See 675 IAC 12) regarding expiration time frames for beginning and
of State and L I f" ,n f;';"'Pletmg constrUctIon.
I, the undersigned, agre~ ~cp.Q.jt.rq,k.t}Q.nli ~consR9!t oW; Qr!I~f!ment, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this applicatlrd~llc&ij)lyWiW,lwM4J~ <6:iRVJ:€.f the State of Indiana, and the "Zoning Ordinance of Cannel Indiana - 1993" (Z~
289) and amendments,~eFreJ!\P,t .C, ~1 eA~~.Bl1} of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floord~ln; are abi~er.t :Hty~ that the construction will not be used or occupied until a Certificate of
Occupanc en issued the Departm 'QDtA1P6A.nity Services, Cannel, Indiana.
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Print \..
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INSPECTIONS REQUIRED: Filing Fees: //rJ ~ ./() ,
Base Inspections: ? ~ ;;; C1 0 # Charged Re-
d ReViews
rt. of Occupancy: S3 . S
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BUILDER
OF
RECORD:
STREET ADDRESS:
t..,j
BUILDER'S EMAIL ADDRESS:
PROPERTY
OWNER:
:r
NAME:
-c....
STREET ADDRESS:
LOCATION
& PROJECT
INFO:
SEWER lJTIllTY
PROVIDER:
w -\-
NAME OF UTILITY EXCAV TION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/DR COUN1Y WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPER1Y: ; uS
TYPE OF CONSTRUCTION:
f1!i SINGLE FAMILY
b TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
TYPE OF IMPROVEMENT:
~EW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
Manufactured
Trusses:
Sump Pump:
_VLN
~V_N
_V iN
_VLN
Signa re of Owner or Authori
Agent
OFFI
wer Foo ;'
=--,
~
l'iinal
der Slab
,
Site
S:Permits/FormS/ILP RESIDENTIAL
PHONE,
FAX:
s;,.....
i3
ZIP:
()yz-
FAX:
STATE:
ZIP:
SECTION:
ZONING:
(
SQUARE
FOOTAGE:
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
000
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Which plumbing codes will be applied to the construction:
o International Residential Code w/Indiana Amendments
~niform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & , BEA~ PIER
o SLAB 0 BASEMENT (WALKOUT~V_N )
~
Addibonal Fees