HomeMy WebLinkAbout06120046 Application
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:
STRaJ61ES
BUILD~ EMe.1L AD~ESS
0\l\\t.e.COW\ \i
N~mi
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~TE
BEST METHOD OF CONTACT:
. (b t'f\ e'C'0lill
PHONE
oq-l
CITY ()
fl. \GtS\'I-\eld
FAX
311- ~
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.--.--. STATE
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SUBp/VISION NAM" . '('\ I "SECTION
I \\ac at lUG1-,- a 1O'009=-B
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SEWER UTILITY R UTILITY _ (\
PROVIDER: ~"v PROVIOER: C' (j, CO~ \
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION ZA BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE):
FAX
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
ZIP
i.J,~~7
Z~\fu
TYPE OF IMPROVEMENT:
ro/ NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) .!3i::IJ C1Y:J
. ...---.....-----.-....... (),.,
" 1 r;-_~l ~--c~. ;-_> -, ,.::tt'7 - - tCJ
. OV c'....; ";"i/:.'. ..'
~, ,:~; " '.".', : 1 ~I ,
PLUMBING CONTRA&OR:Ca.I1;qi~- --Ut iii'"
Lb \\\e~~\cr..nEC 1 2 2005 1:1111
Plumber's Indiana:St:ate License #: i: I ill I
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OD1 u'D- l_..___.__._ n.J C.,-/ !
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Which plumbing codes wi1U?~-"~p.P..IJ~~_~_~~!E~~~_uction: ! _J
o International Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
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lY"1I_ S
ADDRESS OF co
n~3
TYPE OF CONSTRUCTION:
~
o
o
SINGLE FAMILY
TOWN HOME
TWO FAMILY
# of units:
MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
- .
o
PROJECT INFORMATION:
Early Release Manufactured FOUNDATION TYPE: (Check all that apply for the new
_ / /: construction area)
Permit: _Y ~N Trusses: _Y-'L..N
./ ./ 0 CRAWLSPACE
Lot Split: _Y ~N Sump Pump: ~ Y N 0 SLAB
Does any part of the property lie within a special F 'tO~nation area:
Y V'" N
9". POST & BEAM
Ll6 BASEMENT
WALKOUT:
I
Y /N
For Single Family and Two Family dWel~~.n, ~q, __.' , r~~1n lor accessory structures, this permit is valid only if construction commences
within 180 days of the d.. a. t.e.~ ~~~.. .~'dtPbu. w- ~.'~.~t. b.S;;ll.n {ld rou completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I struQL~.:(}mJ}~~)t~~~er . ~ve Rul.es of the Stat~ of Indiana (See 675 lAC 12) regarding expiration
. .~\;;-. cW' fl<'.l . .... .~~.~~'t1~I3i~~~~S\:\\t;~Pletmg construCtloo. .
I, the underSigned, agree t~'Q\V coI'\5'~ . .~hbn~' ~11~, relocation, or alteratIon of a structure, or any change m the use of land or
structures requested by this apPlicatiOI')~ ~~h~form to. all applicable laws of the State of Iodiana, aod tbe -Zooing Ordinance of Carmel
Indiana -1993" (Z~289) and~e~, a~~~ ~lu:~&ity ofJ.C. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
t to. I further certify tha,t-. .' rG...~. ,'~ ai\Ilft.S0\~jihs are connected to the sanitary sewer. I further certify that the construction will not be
sed r occ~p' Gtil a c ~. r OccupancYn.s been issued by t e De\;~tt d Community Services. Carmel. Indiana. I d-11;:;21 tY..a
re of OWner or Authorized Agent Print Date ' ,
EUSEONLY:********************************************t~~,****~*******************
Filing Fees: I~II, 30
INSPECTIONS REQUIRED: ' ...........-:7) # Ch d R
Base Inspections: d7 7- ) arge e-
(!lPPer Footi~ Lower Footi~ Under Slab Reviews
- ~I <;;tJ Cert of Occupancy: 53. 50
~ ~t::..Meter~~ P.R.I.F.: d /.2 r; l 00 Additional Fees
~OTAL': . rlCl-~]' 30
I
\Reviewed/AP eyed: Dept. of Community Services (Date)
S:permits/Forms/ILP RESIDENTIAL Fee Received by:
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