HomeMy WebLinkAbout07030116 Application
City of Carmel! Clay Township Permit #:01030 1/ lp
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
FAX:
NA E: \ t4 Co I t;
~AWRE~eL
BUILDER'S EMAIl ADDRESS:
N~E:
'P<I Q...\ LA f'<-
STREET ADDRESS:
Lt2-L 5'~
LOT #:
SEWER UTILITY
PROVIDER: U~.N\(\d-
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CITY:
~EL
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BEsr METHOD OF CONTACT:
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PHONE:
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FAX:
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CITY: __-::'-1 'i "\.:j 1 \:-.STA{J:""
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SUBDIVISION NAME: \',\ \i ;:-::=::--.- SEmON: \1' 11\\
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NAME OF UTILIlY EXCAVATION CONTRACTOR; Pu\N COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR CQUNn WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTlON:
~INGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
DEPT OF COiJiMU,'J' ry ~~:::I':ViCE~
,
.1-.
~
I .
PA EL #:INDIANA
X-LU'l>Wec(
TYPE OF IMPROVEMENT:
PLUMBING CONTRACTOR:
NA-
o NEW STRUCTURE
o ROOM ADDITION(S)
o PO~CH AD.DmON(S) ~
o ..J>ECK ADOmON(!i!).
./5 REMODELRI;-M~A-T/
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
_v?
_V_N
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction: I
o International Residential Code w/Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments :
,
FOUNDATION TYPE: (Check all tha~~r the 'new
construction area) ~il{ \01IS ".'Y"" __.
o CRAWLSPACE ~ 0 POST & BEAM PIER
csf SLAB ~ BASEMENT (WALKOUT:_V ,/ N)
PROJECT INFORMATIO!!.: ./
Early Release ~/
Permit: _V -7
Lot Split: _V ~N
Manufactured
Trusses:
Sump Pump:
For Single Family and Two Family dwellings. additions, remodels, and/or accessory structures, this pennit is valid only if construction commences wit~ 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. qIass 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 Carmel Indiana - 1993" (Z'
289) and amendments, adopted under authority of J.c. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, floor drains are connected to the sanitary sewer. I further cemfy that the construction will not be used or occupied until a Certificate of
Occupancy, eni ue~ntofconunUrtitysetvic.,.c~~ ~8 N t:S 3 ;1::;107
ature 0 OWner or Authorized Agent Print Date
OFFICE USE ONLY: ******************************~~****** **************7*?ry***fo******************
INSPECTIONS REQUIRED: FIling Fees: .-' I
. . Base Inspections: / I ( () 1)
Upper Footmg Lower Footmg Under Slab r"'" 2 . <0
~ Cert. of Occupancy: .> ;/ ./
CRo;;gh 9 Meter Base ~n~' y .
_ _ _ _ P'R'I.F'~' ,
;'<00 ' TAL". fi 92ft. "v
(Date) ~~
Fee Receiv by:
# Charged Re-
Reviews
Additional Fees
Reviewed
S;Permits,!formS/llP RESIDENTIAL
Date