HomeMy WebLinkAbout07020167 Application
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
SEWER UTILfTY
PROVIDER:
City of Carmel! Clay Township Permit #: 0'7 DlD J /P 1
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
NAME:
FAX:
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BUILDER'S EMAIL ADDRESS:
/nTE:
BEST METHOD OF CONTACT:
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ZIP:
f. os:t>
C -r~ l.0 1:>
WATER UTILITY
PROVIDER: C '" '( ()'V{:.. \
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) ~ l.{ L( I 0 "'=
#- 0'7 02.0 'if.:,
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL ANO/OR SEPTIC PERMIT #'5 (IF APPUCABLE):
X(W'l~1
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
1;8: SINGLE FAMILY , . ;~,NEW STRUCTURE
o TOWN HOME ~/'c ';: ;: \tJ\ROOM ADDITION(S)
o TWO FAMILY ....-:~ '\C:;, ~';:"~D PqRC;~.ADDITION(S)
# of '!.nits\:~n~9j) ~:;::::-- 0 D.~C;:K\~I?DmON(S)
constructed at this J;:;) REMODEL
time:.\'\\ ~ 1 1\)\)1 \\'Ba~ement Finish only
o RESIDE~:r,~~\(FOr c..Q. '2. 0 AScESSOR.Y BUILDING
Additions; ~de~...lt,l ~DETACHED\GARAGE
\\\ 0- """"""'--0 ATTACHED GARAGE
PROJECT INFORMJhION=--- }~.-DEMOLITION
.' .---"
Early Release \ ~. Manufactured
Permit: .......... _V-$-N Trusses:
_Y +N Sump Pump:
Lot Split:
TAX MAP PARCEL #:
',I/;ah6
Which plumbing codes will be applied to the construction:
~Intemational Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
;?< Y_N
XY_N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory st ~,lQe~5~"i . 0llltf i~Y ~s c' ces within 180
days of the date of issuance of the building permit, and must be completed (Certificate up~~ ~~~!rts Issuance date. Class I
structure permits are subject to the General Administrative Rules of the St.ate of Indian~ (See 67_~f2 J,Ilg et~b'time frames for beginning and
completmg constrUcnolf"\.t:?1 ~P..\J\'C-'"
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alte~'i'5n ~~,Tor e ill the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the State In, and the."Zom g Ordinance of Carmel Indiana - 1993" (Z'
289) and amendments, adopted under authority of r.c. 36'7 et seq, General Assembly of the Stat 0 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 CertHica.te of
Occupa.ncyhas been issued by the Department of Community Services, Cannel, Indiana. ~
(\ N""d.J..,y ~ l'dO.", p(' ,,,,.6;..., r-ftv",~~~( -:] 07
Signatureofown~orizedAgent ~ I Da
OFFICE USE ONLY: ************************************* ********** *** **** *** * *,/J?i******** * * ****** ** *
F'!' F . 9'06 '7'(/
INSPECTIONS REQUIRED: ling ees. ,- - -
('LIpper ~~iri~ (COwer Footing/ Under Slab Base Inspections: d7:!? ~
.. '> ~ V Cert. of Occupancy: .d .3. .::>
~g~eter Bas _~n'ii1 Site P.R.I.F.: ./;;Z 'I ()()
C
# Charged Re-
ReViews
Additional Fees
-J...-?....o
Dept. of Community Services (Date)
S:Permlts/FormS/ILP RESIDENTIAL
Date