HomeMy WebLinkAbout06120012 Application
City of Carmel/Clay Township Permit #:1lb.l.2.Q.OJ2-
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
PROJECT INFORMATION:
Early Release \Jl Manufactured v1
Permit: _ Y ----E-N Trusses: ~ Y _N
\/J ./1 0 CRAWLSPACE
Lot Split: _Y....e-N Sump Pump: -/'>LY _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _ Y -l2-N
BUILDER of
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
LOT #/9
SUBDIVISIgtJ NAME )
0(.. ,'r)rcWJ;5
SEWER UTILITY /) /
PROVIDER: L--/ a ,
WATER UTILITY
PROVIDER:
NAME OF UTIUTY EXCAV. TION CONTRACT'OR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR (DUNlY WELL AND/OR SEPTIC PERMIT #'$ (IF APPLICABLE):
TYPE OF CONSTRUCTION:
rFP SINGLE FAMILY
is TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
g
o
o
o
o
o
o
NEW STRUCTURE
ROOM ADDITION(S)
PORCH ADDITION(S)
REMODEL
ACCESSORY BUILDING
DETACHED GARAGE
ATTACHED GARAGE
DEMOLITION
~
STATE
~;V
ZIP
-<10a3~
BEST METHOD OF CONTACT:
!~
PHONE
FAX
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CITY '
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STATE
ZIP
DEe
_ s~
i'rk-
ZONINGJ _ /
SQUARE SIO ")
FOOTAGE: 7 0(,
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o
~
POST & BEAM
BASEMENT
WALKOlfT:_ Y $N
For Single Family and, T, wo Family dW, eHin, g, S, additions~tif\l~f~/or accessory structures, this permit is valid only if construction commences
within 180 days of the ,d~e... oJip~Il';~f:the-.~mg wahtk~, kh~tYm~st be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Cl~s~~~i~S ~~ ~u~e~J'Il-R t.w ~ti\a.~nistrative Ru~es of the Stat~ of Indiana (See 675 lAC 12) regarding expiration
I, the underSigned:~~~m~~~&r;~~~#~~~~;~ng ~~to~~~!~~~~nJt~~:t~~~~:l:~'ructure, or any change in the use of land or
st~cture,s requested b~J~~.._.',S a~ ,. f$....W .~\-A.U.ffi')1WI~t~~iU1Yanzt~fd'r~~--:- iapplicable laws of the State of Indiana, and t~e "Zoning Ordinance of Carmel
Indiana,~ 1993~ (Z- 289.I*!J~~~e~~M"9.I?1tecr~e~hp0xf~ !7et seq, General Assembly of the State of Indiana, and all Acts amendatory
there~~. I further cert.iiY..wi,~~ttr1t'tb\.JcNf~ lrrains arc connected to the sanitary sewer. I further certify that the construction will not be
us r occupied un.~~tl'rhlkate of OC f~een issued by the cpartm..Tf Community Se ices, Catmel, Indiana,
/,). '-1-0&
Print Date
*****~*************
,'7 9
****************************
Filing Fees:
INSPECTIONS REQUI
GPper'''o~ Lower ~oo~ Under Slab..
CRough I~Meter~ ~ ~
,-:) -? 7 )()
# Charged Re-
Reviews
Base Inspections:
Cert of Occupancy:
P,R,LF,:
.
CY1L~~ t-115-e-r I:Z-b -06
Reviewed/Appro d: Dept of Community Services (Date)
S:Permits/FormsjILP RESIDENTIAL
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Fee R
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(il ()() A~ditional Fees
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