HomeMy WebLinkAbout06100200 Application
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City of Carmel/Clay Township Permit #: 0 (; J (J1)~ to
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
NAME;
IIIVdTi-t
ff~
PROPERTY
OWNER:
STREET ADDRESS:
LOCATION
& PROJECT
INFO:
LOT#:
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SEWER lJTILIlY
PROVIDER:
PHONE:
FAX:
'-I'')
CITY:
STATE:
ZIP:
mY:
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ZONING: Af'U
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..... / SQUAI<f
FOoT GE:
EST1MATED COST OF CONSTRumbN:/.I. ~
(EXCLUDING LAND VALUE) '/P/)O O"'V
SUBDIVISION NAME:
IN f!- yt:T ~ L ft-
'7tf"O
NAME OF umLITY EXCAV ON ONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND'OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
TYPE OF IMPROVEMENT:
~ NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S}
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
PROJECT INFORMATION: 0 DEMOLmON /
Early Release - / Manufactured ~ /"
Permit: Y L/N Trusses: _Y ~
Lot Split: .y ~ Sump Pump: _Y _N
o,...,1::'t)l'.:'!,. ,t:'t""lP ("':,.....t\!~T
FLOOD ZONE AREA DESIGNATlON(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions, Remodels. Etc.)
1
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TAX MAP PARCEL #;~. L'"
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PLUMBING CONTRACTOR: .
eRA-if tJlU,.).fjl~
Plumber's Indiana State License #:
pC- - /0> eD'7,'2 (
i, IRiJ r>f?:>
Which plumbing codes will be applied to the construction:
)23 International Residential Code w/Indiana Amendments
o Unifonn Plumbing Code w/lndiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & 6EAM
o SLA6 y4 6ASEMENT (WALKOUT: Y. Y
_PIER
N)
For Single Fam!lx..~fLI'1:"~S~ilYif!YfS~ijMs;,~,t!9>>~;t!'~lGmPlor accessory structures, this permit is valid only if construction commences within 180
days of the date of issu~se pf~~e,q!;lilding-p'egnitj and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure pennits are subJ~tdb'tlie GeH~riI"A-anliiiiM.raB.~e Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
DEPT OF COM:vlUNITY SERV ingcOMtruction.
I. the undersisnti~r~rr1th.at-arw ,comG!1Jfti9q,~tlfC~t:ruSFiqw..m.~FIIYJlt, re arian, or alteration of a structure, or any change in the use of land or structures
requested by tl\tslapplic'atibn \.Ml'l0\h1hywiclt, an1:li:oqioiiTtio; au ]M>li~able laws f the State of Indiana, and the "Zoning Ordinance of Cannel Indiana - 1993" (Z~
289) and amendments, adopted under ~Wl@1liJ.): PO: . 36~ 7 et seq, General Assembl of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the anitary sewer. I further cer' that the construction will not be used or occupied until a Certificate of
Occup:y1cf beel}...~d by the D. epartment f Community S . cetfanne, Indiana.
V- ~ ,,\I . >T\Z'V ~ K'DT/1 J/)'- '2 7-0f.,
Signature of OWner or Authorized Agent Print Date
OFFICE USE ONLY: ************
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Filing Fees:
Base Inspections:
Cert. of Occupancy:
# Charged Re,
Reviews
Additional Fees
Date