HomeMy WebLinkAbout07040017 Application
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City of Carmel/Clay Township Permit #:~1
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, 8. Two Family: New Structures, Additions, Remodels, 8. Accessory Structures
BUILDER
OF
RECORD:
NAME:
D
PROPERTY NAME:
OWNER:
LOCATION
8. PROJECT
INFO:
STREET ADDRESS:
PHONE: FAX:
CITY: STATE: ZIP:
I~ 'Ii '6
BEST METHOD OF CONTACT:
PHONE: FAX:
(3/
cm: STATE: ZIP:
I
SECTION: ZONING:
3 $-1
SQUARE
FOOTAGE: I 30
LOT #:
q
SUBDIVISION NAME:
L
ADDRESS OF CONSTRUCTION:
SEWER UTILITY WATER UTILITY
PROVIDER: PROVIDER: C
NAME OF UTIlITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); ANDIOR COUNTY WELL ANDIOR SEPTIC PERMIT #'S (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY;
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
/ time:
r:2' RESIDENTIAL (For
Additions. Remodels. Etc.)
o Uniform Plumbing Code wI Indiana Nnendments
. O~.
FOUNDATION TYPE: (Che~~~qliIPIY for the new
construction area) "O~~ ~\~.
o CRAW~~~\'I\~\ ~~#=~W' _!,ER
O~~\W:~~. o~ ~y---LN)
For Single Family and Two Family dwellings, additions, remodels. andlor accessory stm~~5t.~\~tJ~~ ,f'c.~~ ion commences within 180
days of the date of issuance of the building pennit, and must be completed (Certificat~~~~pluk.x~'if \ I' ~fis of the issuance date. Class 1
structure permits are subject to the General Administrative Rules of the St.ate of Indian~ ~S IAt2'In tfi ~W'~;'J.l\ira~~ime frames for beginning and
completmg construction. :-( O't ~~\~ (\\~; .
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alterati.9.R;P~ ~:..~~r an~~'10ge in the use oEland or structures
requested by this application will comply with, and conform to, all applicable laws of the State of I~n ~he ~Zoning Oroin3nce of Cannel Indiana - 1993" (Z~
289) and amendments, adopted under authority of LC. 36-7 et seq, General Assembly of the State 0 . a a, and all Acts amerid~tory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the const ction will not be used'or occupied until a Cerafkate of
Occupancy has been issued by the Department of Community Services, Cannel, Indiana. ", '"
Early Release
Permit:
PROJECT INFORMATION:
y~
y ~
Lot Split:
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDmON(S)
o PORCH ADDmON(S)
D/f)ECK ADDmON(S)
Ili'f RE'1l'DEL
1 Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATIACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
~y_N
~y_N
Sump Pump:
ESTIMATED COST OF CONSWUCTION:
(EXCLUDING LAND VALUE) "1 ()()
J"b
lflJ/07
loll, A, 13: Rb.<';N-I(,- JIE;AlI;tJE
Print
D.le
j/ 307 (JtJ
,
C
Reviewed/A roved: Dept. of Community Services
S:PermitsjFormS/llP RESIDENTIAL
(Date)
~~b?~
Fee Received by: /
OFFICE USE ONLY: *********** ** **** ****** ************** **** ******* * * **********~*** *** ******* ******
INSPECTIONS REQUIRED: Filing Fees: /3!: J ()
. . Base Inspections: / /) . d {J # Charged Re.
Upper Footmg Lower Footmg Under Slab _ () Reviews
~ ~~ Cert, of Occupancy: S'::> ' .:),
Rough Meter Base Final Site;
_~ P,R.I.F,: Additional Fees
Date