HomeMy WebLinkAbout07040183 Application
City of Carmel/Clay Township Permit #: o1n'-foltl3
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, lit Two Family: New Structures, Additions, Remodels, lit Accessory Structures
BUILDER of
RECORD:
BUILDER'S EMAIL ADDRESS
PHONE Y6 -2 '11j.. FAX
I
BEST METHOD OF CONTACf:
(v. ,.--
PHONE FAX
NAME
PROPERTY
OWNER:
NAME
STREET ADDRESS
LOCATION
lit PROJECT
INFO:
LOT #
';-'1 SUBDIVISION NAME)k" H rJ.
It
,_~~m--~.~.5TATE"-'--- -~~- .ZIP
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.. I SITON
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CITY
SEWER UTILITY
PROVIDER:
ADDRESS OF CONSTRUCTION
i
(7Jl W r?
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TYPE ~F CONSTRUCTION:
B" SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
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Icense #: ~~'!J.;'"
/ () )~ r d"l "" ,,''>>-
Which ~'Umbing codes will be applied to the construction: ~,
~ernational Residential Code ~ IIndiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code) O~\
PROJECT INFORMATION: 1~ ''"'~ ;
Early Release Manufactured /' FOUNDATION TYPE: (Chllm,:Q)~~~~IV for the new
Permit: _Y _N Trusses: ~Y __NN co~tr~::L~::~~'" v~~~~~,s~ c:,.~~ i
lot Split: _Y _N Sump Pump: Id-SLAB ~U~\,C0~~B-X~ ~c:,'0 ~.
Does any part of the property lie within a special Flood designation area: ~1>~9\~c ,,0 ~A ._ Y ~
For Single Family and Two Family dwellings, additions, remodels, and/or accessory~ ~\, ~\~ ali~G if construction combences
within 180 days of the date of issuance of the building permit, and must be complet~ ertific~f'gc~~\.y l%..~ within 18 months 'of the
issuance date. Class I structure permits are subject to the General Administrative Rules of tJ,l~a~oU~~\~'l5"15IAC 12) regarding expiration
time frames for beginning and completing ~uftJtmY
I. the undersigned, agree that any construction, reconstruction, enlargement, relocation, or al(er~ W; strucrure, or any change in the USe of land or
suuctures requested by this application will comply vvith, and conform to. all applicable Jaws cGl\~ State of Indiana. and the "Zoning Ordinance of Carmel
Indiana -1993" (Z~289) and amendments, adopted under authority of LC. 36~7 et seq, General Assembly o[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 oc pled unt J a C tincate of Occupancy has been Issued by the Department of CommunIty ServIces, Carmel, IndIana.
Signatur~ o~ner or AuthOri~ pi? L C-rz \J C r
TYPE OF IMPROVEMENT:
CYNEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
NAME OF lJTlUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
y- 'Z >~o7
Date
OFFICE USE ONLY: **********************************************~*****************~******
Filing Fees: GJ- ~ :? :KO
INSPECTI D: ''''7 /() ,
Base Inspections: r/O _ J # Charged Re-
A Reviews
Cert. of Occupancy: ,::;' S-5v
P.R.LF.: I J (;/ (JO Additional Fees
~~~tIYcJ- PD
Upper Footing
Under Slab
Meter Base
Final
Site
C.I'OvL:;t M t~1!./ 4--7b- 07
Reviewed/Appro d: Dept. of Community Services (Date)
S:Permits/Forms/ILP RESIDENTIAL
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