HomeMy WebLinkAbout06110106 Application
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\City of Carmel! Clay Township
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
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permit#:~
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
.DER of NAME E:'T~IDt..c PHONE 3 i7-- (.(.,:>- 8 51. <:> FAX 3.1'1 -'815 - z.S't <..
'-'-""TO H H-oM-C'>
~ORD:
STREET ADDRESS CITY STATE ,--1 ZIP 4l.OTL
11;~o L"-A..'I "1l:;~Ac..c t3..-.v'L> s-r<: 7~c. C.N..M.El-
BUILDER'S EMAIL ADDRESS BEST METHOD OF CONTACT:
O<->e"fe ...~+.;J,e. . ~ct <l......~c...ll
. PROPERTY NAME e "-( /for< 00 PHONE &G,~- 8530 FAX
...'-<- 815-Z:Sl'-
OWNER:
STREET ADDRESS CITY STATE ,J ZIP
143"0 '-~-f -refi{/A (€ l1'-lI'D ,T<: ~O>O 4'-fZ.I"<:L 40)'-
LOCATION LOT # SUBDIVISION NAME 'wb, SECTION ZONING: p
& PROJECT 4,Sr V '~At.i Uf '-l-.A-( ].0'-1- A- vD
INFO: ADDRESS OF CONSTRUCTION SQUARE .9 Sl',8
'88{" et<ETT.!>C\v"--( St. FOOTAGE:
SEWER UTILITY Cw.-( I WATER lfTILITY 0JtJ.<a- r ESTIMATED COST OF CONSTRUCTION: t I W En-s
PROVIDER: PROVIDER: I (EXCLUDING LAND VALUE) . S (. '-(
NAME OF UTIllTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET ' -----' ,
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE): y:rJoA-O~ rt: {O~"O I OS
PROJECT INFORMATION:
Early Release Manufactured
Permit: - _Y..$..N Trusses: 1..Y _N
o CRAWLSPACE 0 POST & BEAM
Lot Split: ~Y ~N , Sump Pump: .;zs....Y _N 0 SLAB }>l:' BASEMENT
Does any part of th<; ,Pr.~p.!'r!;Y,lie w't I -l!lT1Gf1l designation area: _ Y LN WALKOUT:_ Y-----K-N
For Single FamiiSl, . ,11 . withle.lb~i,9 rs. and/or accessory structures, this permit is valid only if construction commences
,within 180 da~~. ',' e ~E'~Jkrmit, and must be completed (Certificate of Occupancy issued) within 18 months of the
~ssuance date. Class I strucOtrlJ&\4ll.,~ ~~~.ministrative Ru~es of the Stat~ of Indiana (See 675 lAC 12) regarding expiration
'- ncPT;'t:'\F COM~1t, . frht\e';]~r~ and completing construction.
I, the undersigned~ t!\ar:'.a;lY A~1j~iii'(O .:c,~rulQN',,(H!-l!t'di\cnt, relocation, or alteration 2L:,J structure, or any change in the use of land or
structures reques~tGIP~fP~, 'i;!!fJi:vith, and conform to, all applicable la\vs of the State of Indiana, and the "Zoning Ordinance of Cannel
Indiana -1993" (~'Mjfand amcndment\N1j), .~er mity of l.c. t seq, General Assembly of the State of Indiana, and aU Acts amendatory
thereto. I further certify that only kitchen, bath, and or drains arc connected to e sanitary sewer. I further certify that the construction will not be
usf~ or occupied until a Certificate of Occllpa has been issued by ttJr Depar ent of Community Services, Carmel, Indiana.
" ;.4'^- a,d ~O-.- I vI J.U r;::::: - o.,cJ
Signature of Owner or Authorized Agent 5 Print
Filing Fees:
Base Inspections:
Cert. of Occupancy: ':;5 . SC)
P.R.I.F.: /J (; /. n 0 Additional Fees
L/-~~t,l),:" 'I JU 9 J d
(<t?~;?' ((___--J--(L"r'
TYPE OF CONSTRUCTION:
;gf SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
)&' NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
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,,'
'.
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OFFICE USE ONLY: *********
INSPECTIONS REQUIR ~.
dIiiPe"r Foot~ L~er r-6ot~ Under Slab
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C ROUgh~Meter~<:fin"al ~
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ReviewedjAp oved: Dept. of Community Services (Date)
S:PermitsjFormS/llP RESIDENTIAL
Fee Received by:
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.!l
PLUMBING CONTRA~OR:
I!-TJo.(.~i\ \ i NOV 2 1 2006
Plumber's Indiana Statl,.Llcense #:
I'"' ,-
10052.-0 l___,. --- ------...----
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!'
j, '~:j
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Which plumbing codes ..,Jill.be,appJied,to the construction:-~-
..8J International Residential Code w/Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
"/Z./bl.,
Date I '
# Charged Re-
Reviews