HomeMy WebLinkAbout04120042 Application
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City of Carmel/Clay Township Permit #: tJ Lf/~ 00 '/:::<
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of NAME
RECORD:
PROPERTY
OWNER:
STREET C\'D
BUILDER'S EMAlL ADDRESS rV1
I II f:Nl~
NAME
,~\
...!->N
STREET ADDRESS
STATE
LOCATION
& PROJECT .
INFO:
ADDRESS OF CONSTRumON
/"
SEWER UTlLITY
PROVIDER: C,:
;J;J I' {>
ESTIMATED COST OF CONSTRumON:
(EXCLUDING LAND VALUE)
WATER UTlLITY
PROVIDER:
NAME OF UTlLITY EXCAVATION CONTRACTOR; PlAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
:+
@(l/).(j
FAX
ZIP
ZONING:
SQUARE
FOOTAGE:
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
ft SINGLE FAMILY )( ~8N EURE ft/.-y( C-ra
o TOWN HOME :~\'fl.tllSM ONeS) Plumber's Indiana Sta~License #:
o TWO FAMILY CO\l!f mON(S) I
# of units: ~'C.O fO? e'lol~ll.\ DEL IJ>/() q
o MUL ll-IV\a1L~ GofC\P\\anc l.oc@JC ~ DIN Which plumbing codes Jill be applied to the construction:
# "ect\O 'nO 'T"/'l"""
AdditiOnS,B~e@,Ii:f.<: ^\:.\...I W~EMOur?O~ARA '0 Unifonn Plumbing Code w/Indiana Amendments
\) ~ti:p-P-Iv' 1p..1ip.. (Multi-Family Construction COde)
PROJECTIN~ _: IND FOUNDATION TYPE..
(Check all that apply for the new
EarlY.Release V Manufactured construction area)
Permit: -A-Y _N Trusses: A-Y_N
\./ 0 CRAWLSPACE 0
Lot Split: _y X-N Sump Pump: _Y;A-N ~ SLAB / 0
Does any part of the property lie within a special Flood designation area: _ Y _N
POST & BEAM
BASEMENT
WALKOlIT:_ Y-----;--N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction comrhences
within 180 days of the: date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits 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 Cannel
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 funher certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
used J\ occupied untO Cercwcace of Occupancy has been issued by the Depa~ent of Community Services, Carmel, Indiana.
',orw~_" (~"f&e )2-6 -07'
Print ---::J Date
ONLY:********************************************************************~***
Filing Fees: to :2-:l.. '8 C> .
INSPECTIONS REQUIRED: Base Inspections: f-. (j)(), () () # Cha~ged Re-
pper Footing . KrJI. ~ '1) ReVlews
Cert. of Occupancy: ~CL ~ 'IL U-
P'R~IF rT'J'AL~'1i!!i'f. r,O -~'7
~~ ~d_J-. /2-';> 1- -c;l->
Fee ecelv d by: {. ,