HomeMy WebLinkAbout06030130 Application
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City of Carmel/Clay Township Permit #: D bo3 O/?{)
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RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
I
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME
LIe..
STREET ADDRESS
I ....r- L
BUILDER'S EMAIL,ADDRESS
I'A-vi :-\' ~V' ~-'t\c.c...,,'f\
STATE ZIP
0.0. -L
BEST METHOD OF CONTACT:
. CD~ ,IU 4,7
PROPERTY NAME PHONE FAX
OWNER: 6c.o \(~~'-D \
CITY C STATE ZIP
13 " QH"j';:) L-~
LOCATION LOT #
&. PROJECT ~r""'\.M...S
INFO: SQUARE
"'" rt'l'O..u L.1:lo.y.)~ FOOTAGE:
SEWER UTILITY WATER UTILITY ..uJw...- ESTIMATED COST OF CONSTRUcnON:
PROVIDER: oj W..~L PROVIDER: ':!'."<l ls (EXCLUDING LAND VALUE) 'I\> '2..00 COC)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
PROJECT INFORMATION:
Early Release Manufacture FOUNDATION TYPE: (Check all that apply for the new
Permit: _ Y ......If' Trusses: construction area)
~WLSPACE 0
Lot Split: _Y VN Sump Pump: 0 SLAB 0
Does any part of the property lie within a special Flood designation area: _ Y ~
l',~' ;-'.'. '/~',"", _......_. "~
.__',_n~,"_ W, \..,1..', ;:: l_ "l} , :
Fo~ S~gle ~mtJrF.~if;-VR(f~y~~~~~n~~ha<;.d~tio~s, r~hiqdl...~ and/or accessory structur~: this permit is vali~ only if c~ns~ruction commences
WIthin 180 iffys bf the aa~e Ohls!Jtl. . ame at.the lfuliJilig'p\!lm1lQiiil1 must be completed (Certif~cat rfl~' . thin 18 months of the
issuance date. Class I sfrUCtli.ritpefriiid. are'subjet;t;ro:)ae General AdministraB. . a. ,) regarding expiration
DEPT OF (~m!IM: 'Nn"i"'d~/E' 'ningand 'n '
I. the unde'l'~8Iled, iW~ ~~a&Yft.c.9:nstru1:dQn, reco~5t.fc'ti!ln, ement, rdoc , t tion 0 a structure, or any change in the use of land or
strUctures It!tfues&d'bfth1~~l{tloJ.will~~wiFOhVN ' . ,all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993" (Z- 289) and amen~ A.J>Ad under authority of LC. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen: b~th, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
used or occu. ~til a. Certilicl4"te of Occupancy has been issued by the Depanment of Community Services, Carmel, Indiana.
, }', / \\"-:;AV \L \1-'1.>'-..( '?> -- n -~,b
~er or AutlfOrized Agent Print \.) " Date
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
~ESIDENTIAL (For
Additions, Remodels, Etc,)
Signature
IS.
TYPE OF IMPROVEMENT:
o NEW STRUClURE
cg---ROOM ADDmON(S)
o PORCH ADDmON(S)
:~tti:MUDEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARA E
o DEMOLmON !
PLUMBING CO'- . . R' rfc; n ,,/1 i ~c:'; '\'\ I
\\~\V\.- ~\ ~i':/_0? ,,__,1 c=~ III
Plumber's Indi~n ' tfi'te Licen. #: I 1
C. I DOO\ I,l MAR I 7 2006 I
~. an I'ed ,I
w t:-!!r.p~th.e..canstr : I
esidential Code w/Indiana Amend~ nts
o Unifonn Plum 'n9 0 e w Ilndiana Amendments I
(Multi-Family Censtruction Cede)
Which plumbing axJl
~mational
POST &. BEAM
BASEMENT
WALKOUT:_Y ~
OFFICEUSEONLY:************************************************************************
, Filing Fees: 1/ & 1'/
INSPECTIONS REQUIRED: ,it" / ,
Base Inspections: / C -((I # Charged Re-
/ if, I ~ ReViews
Cert. of Occupancy: S/ .i'O
! Lower Footing Under Slab
BaS~)' ~ 3'
P.R.I.F.:
Additional Fees
c:::;fUv-
Reviewed/Appr ed: Dept. of Cemmunity Services (Date)
S:PermltstForms{IlP RESIDENTIAL
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