HomeMy WebLinkAbout06110120 Application
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CIty of Carmel/Clay TownshIp Permit #:
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
FAX
S8J -cF/5 .3
ZIP
&-.,eJ3OL
STATE
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BEST METHOD OF CONTACT:
3").2
PROPERTY
OWNER:
PHONE
FAX
STREET ADDRESS
CITY
STATE
ZIP
LOCATION
& PROJECT
INFO:
IO~
LOT #
SEmON
ZONIN:5 _I
SQUARE 5 )
FOOTAGE: ;:) d <.9
SEWER UTILITY
PROVIDER:
NAME OF UTILITY EXCAVA ON CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S}; ND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TYPE OF IMPROVEMENT:
00 NEW STRUCTURE
is ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
i5~
PLUMBING CONTRACTh /
..(~/\ /Y7~r' A1,ra.
Plumb~diaria State License #:
8/0 &, <!)</()
TYPE OF CONSTRUCTION:
&l) SINGLE FAMILY
[] TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Which plumbing codes will be applied to the construction:
~Intemational Residential Code w/lndiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
Early Release "',' ~anufactured ,/1 FOUNDATION TYPE: (Check all that apply for the new
Permit: _ Y ~N_ ,_ ~rLisses: d , --l:=!- Y _N construction area)
. VJ .: '!': ., "!'\': "'u..,v1 0 CRAWLSPACE 0 POST & BEAM
LotSpht: _Y ~N', Ilsum~p '",\~Y _N 0 SLAB rn'1 BASEMENT
, ~"f It\II\f4tti,Jt;~ > 'i'JlYi[:Lik~ ./1 'r
Does any part of the pro e .~" '. '3'flII'l""~'Flood designation area: Y -l=!-N WALKOUT:
For Smgle F " wl~ij~~' b~i9~tsi' J, .J..B?dels, and/or accessory structures, thIS permIt is v~hd ani>: If construction commences
~thm" ~~\~ ",,~fi: ,.'. I~ od must be completed (CertIficate of Occupancy Iss-uea) Within 18 months of th,e
ISSUanCe dso~~~b'~\, e":mitU ( ~ al AdmmistratIve Rules of the State of IndIan~ (~ee 675 lAC 12) regarcgpg expiration
_--:. -, d~M'!!'.::I~:t;..b.."f1 !JrlJn'esforbegmmngandcompletmgconstructIon ,'l'~', ~\f\\' ') 2 'LOUD .
I, the unders~_ t.th~aru ~~~!econstructlon, enlargement, relocation, or alteration of a srructur~'?T any cmn~e drrhe use of land Of _.:.- I
structures re d.. :~g~~~ply WIth, and conform to, all applicable hws of the State of lndl~n~ and the "Zomng Ordl}!:.'!-Ilce of Carmel '
... lpdiana -19~ an amend~, a~o.pted under authorIty of I C 36~7 et seq General Assembly of the State of IndIana and all ACts amendatory
;~thereto I fu~; c~rtIfy that only kitchen bath and floor drams are connecte to the sanitary sewer I further certify that the construction Wlltnot be
, {: :{.l.ise cupied u il a Certificate .ccupancy has been issued by the epart ,t of Community Servic~, Car~~l, Indiana.
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Print
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bate
SPECTIONS REQUIRED:
****************************** **********************
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V ~3 SO
Filing Fees:
OF
nder Slab
Base Inspections:
# Charged Re'
Reviews
Site
Cert. of Occupancy:
P.R.LF.: I J- (/ () (I Additional Fees
/.// o-(~/4ff;26()3(,O
C-~L~ceY-0?~
Fee ~d by: ,/
,j ~
e : Dept. of Community Services
ESIDENTIAL
-'Zf-~
(Date)