HomeMy WebLinkAbout06120091 Application
City of Carmel/Clay Township Permit #: V (a,l;<.oocrJ
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
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PHONE:
FAX:
S-
I
I
;,,3
BUILDER
OF
RECORD:
NAME: ,
l~cCCtk,^
STREET ADDRESS:
S"'?
OTY:
.STATr:
rl'-'A
ZIP:
BEST METHOD OF CONTACT:
BUILDER'S EMAIL ADDRESS:
PROPERTY
OWNER:
NAME:
'1b I-
STREET ADDRESS:
LOCATION
& PROJECT
INFO:
SEWER UTlUTY
PROVIDER: C T I<. VII ()
PHONE:
FAX:
(]
ZIP:
v1/ A5J.{,.; G j.,.,J 8/ vcr;: .:C.J) .
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STATE:
WATER UTlUTY
PROVIDER:
NAME OF UTlUTY EXCAVATION CONTRACTOR; PlAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S) . I ~
FOR THIS PROPERTY: ~!.r-~
{ v.wslv<JeJ
Cf 'l f.?~ I 000
u ['''10 '~:e/1
,~~~: p,~" tJ,~c' ~.i'k
cl7'}- 'P ~:}t~';pCJJ'lf?,as"'f00, 1-r~D~~
WhiC~~J::~~~i~ill~Y.!!r~.rlb~~ ~~~ion:
D .Jntemati~~~~e'M.i~<fIle;w.1tri~'J.mendments
6 Unifonn P~~6d4)N~~ia~~g:endments
FOUNDATION TYpif! (CheCk~' ~t!lpIY for the new
construction area) ""$
D CRAWLSPACE 0 POST & BEAM PIER
D SLAB ~SEMENT (WALKOUT:_Y ~.....r()
TY~" CONSTRUCTION:
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release /..
Permit: Y N
Lot Split: Y ~
TYPE OF IMPROVEMENT:
~EW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o DECK ADDITION(S)
o REMODEL
~ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
Sump Pump:
_Y~
.......y_N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences with!n 180
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana -1993" (Z~
289) and amendments, adopted under authority of I.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a CerciBcate of
Occupancyhas been issued by the Department of Community Services, Carmel, Indiana. I
~-6- W ~ V^i:~ W ~,J""tA _ g J, !tD (
signature of OWner or Authorized Agent Print Date , /
Under Slab
# Charged Re-
ReViews
Site
P.R.I.F.:
~",~wedJApprOved: Dept. of Community Services
~ ."IFo'm,jlLP RESIOENTIAL
(Date)