HomeMy WebLinkAbout07040002 Application
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City of Carmel/Clay Township Permit #: O"7oy'OOO~
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:
NAME:
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c
STREET ADDRESS:
\\\B 0
BUILDER'S EMAIL ADD ESS:
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NAME:
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STREET ADDRESS:
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PHONE:
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FAX:
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CITY:
BEST METHOD OF CONTACT:
PHONE:
"b\
CITY:
FAX:
STATE:
\u
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ZONING:
SECTION:
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SQUARE
FOOTAGE:
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WATER UTILITY
,e~ PROVIDER:
NAME OF LmLITY EXCA ON ONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPEDF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
/ time:
Il!I RESIDENTIAL (For
Additions, Remodels, Etc.)
Which plumbing codes will be applied to the construction:
o ;nternational Residential Code w IIndiana Amendments
~ Uniform Plumbing Code w/lndiana Amendments
!
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 pos~~ BEAM PIER
o SLAB ~ BASE~'!$I~~_y-=zLN)
For Single Family and Two Family dwellings. additions, remodels, and/or accessory structures, this permit is Lll\~~\~on ~W within 180
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy iS~~' ]~~. ..j~. ~tf?f ~'b11.' u~'date. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 u.w;t)) \-e~ 1 ~~,JJ.sn~ ~ r beginning and
completing construction. ~..... O~r.O :,.,~\~\~ ":,\Q
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or a ~~O~~h~J~use.Of land or structures
requested by this application will comply with, and conform to, all applicable laws of the State ,~ ~~~g " ~"?f~(~.armel Indiana - 1993" (Z'
28 and amendments, adopted under authOrity of LC 36-7 et seg, General Assembly of the Stat Indiana, il'\~~ct ~.. ~rero. I further certify th" only
kit en, bath, and floor drains are connected to the sanitary sewer. I further certify that the constru~~ Wttl .. s .. upied until a Certificateo!
Dec ancyhas been issue by t e artment of Conununity Services, Carmel, Indiana. '0'" 0<(
. IEW-.-< ~. y.,t;.~\ "
Print
PROJECT INFORMATION:
Early Release
Permit:
****************************************************************************
INSPECTIONS REQUIRED" Filing Fees: .I :7.,? S?J .
" Base Inspections: / / S dO
Lower Footing Under Slab I <" ____ /.
E- Cert. of Occupancy: . 'S J,' ) U
Meter Base Final Site")
_ ~ P,R.I.F.: Additional Fees
~~ $3J7 dO
Fee Received by: Date
Lot Split:
Signa re of ~ne 0
OFFICE US
Upper Footing
~OUg~
y vr: .
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TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
So DECK ADDITION(S)
Il<l REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
Manufactured
Trusses:
~/y/
Sump Pump:
:)
Dept. of Community Services
S:Permlts/Forms{ILP RESIDENTIAL
ESTIMATED COST OF CONSTRUcrrON: ~
(EXCLUDING LAND VALUE) <t> 0
'" 0.00
! '\\ L
~" I r ,
TAX MAP: PARCEL #:
ih\1
III III
PLUMBING CONTRtCTOR:
,u~
~kJ '1-r,",,,,~~ .
Plumber's India~ State LI ense #:
~ BBBooOb.'3
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# Charged Re-
Reviews