HomeMy WebLinkAbout04120077 Application
City of Carmell Clay Township Permit #:IJL/ /:x 0077
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, MUlti-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
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BUILDER of
RECORD:
PROPERTY
OWNER:
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BUItDER'S EMAIL ADDRESS
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NAME
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STREET ADDRESS
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ZIP
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BEST MElllOD OF CONTACT:
PHONE
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Plumber's Indi na
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o I~jftllirlld Reskjilmi;d:CiQfjil~;i~r1l!j~l!lmdments
lJd"Uniform Plgt,,i61i1/fcl\l~ J.1'WIi~endments
(MiAliiF?Mi0fiinSirSiCMI'vMObI TY S E RVI C E S
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_Y .-tN ;r,::,~~~ured _Y /N mnstruction area) INOIANA i
;/, I/"V"' 0 CRAWLSPACE 0 POST & BEAM
Lot Split: _Y _N Sump Pump: _Y _N 0 SLAB /' CB-IlAsEMENT /
Does any part of the property lie within a special Flood designation area: _ Y ~N WALKOUT:_ Y ~N
LOCATION
& PROJECT
INFO:
LOT # __
'39&
SEWER UTILITY
PROVIDER: C I R. '^' 1)
NAME OF UTILITY EXCAVATION COI'ITRACTOR; PlAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUf'lTY WEll. AND/OR SEPT1C PERMIT #'S (IF APPUCABLE):
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc,)
TYPE OF IMPROVEMENT:
rn" NEW STRUcrURE
o ROOM ADDmON(S)
o PORCH ADOmON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
eJ ATTACHED GARAGE
o DEMOLmON
PROJECT INFORMATION:
Early Release
Permit:
SECTION
A(' 0'2..-
ZONING:
P",,-f:)
SQUARE 7
FOOTAGE:
()
ESTIMATED COST OF CONSTRUCTION:
(EXa.UDING LAND VALUE) 0 0 .:. 0 a
~
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences
within 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months oE 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 Cannel
Indiana -1993" (Z~ 289) and amendments, adopted 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, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
used or occupied uuril a Cerrifi(lte of o..ccupancy has been issued by tbe Department of Community Semces, Carmel, Indiana.
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Signature of Owner or Authorized Agent /,~..print'\. ~
OFFICE USE ONLY: *************************~\**********************************************
U~I Filing Fees: II!(",) . tJ()
INSPECTIONS REQUIRED: I ~ . ? 1-0 ()
se Inspections: ,...16 . 0 # Charged Re-
oot'" Lower Foot'" - Under;\Slab ,k',(l 00 ReVIews
~ Cert, of Occupancy: v (L'
~al .. Si P.R,I.F,: 5'J.TJ, CO Additional F/
/ ro:;AL: -" 0 D V
Reviewedj Approv ept. of Community Services
S:Permlts/FormS/ILP RESIDENTIAL