HomeMy WebLinkAbout07050001 Application
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City of Carmel/Clay Township Permit #; o7ct)Q!)Dl
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:
DK
ADDRESS OF CONSTRUCTION:
L{OL Lo!"::::,
SEWER UTILITY
PROVIDER: 641tr'Vt eL
8L
/ (,.,. PHONE:
rv/YlPS
FAX:
c~fL STrb ZIP: U3
BEST METHOD OF ~NTAcr:
LtElN. . 0~r\ll-toM6S,CD
FAX:
41
CITY:
Ow2:MEL
STATE"
l(J
ZIP:
Lf(d) 3 L-
~ING: ". \
~~Dty.J Tl
SECTION'
'8:-
Lf(cQ3L
SQUARE
FOOTAGE:
SID
u
ESTIMATED COST OF CONSTRUCTlON:
(EXCLUDING LAND VALUE) .
NAME OF LfTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
C.' I.::J-
Subject to compiiance with all regulations
IC',... r-l!r, I'"
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERn':
TYPE OF CONSTRUCTION:
~GLE FAMILY
~ ~~;"'N HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
o NEW STRUCTURE
o ROOM ADDITION(S)' Plumber's Indiana State License #:
o PORCH ADDITION(S) ~
o D AD ION(S)
;2~DE~ ~~h AI. Tf hich plumbing codes will be applied to the construction:
./ ""I:....~asement FiniS on y
o ACCESSORY BUILDING 0 International Residential Code w/lndiana Amendments
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOlITION
M~
TYPE OF IMPROVEMENT:
Early Release
Permit:
PROJECT INFORMATION:
/'
_Y ~N/
_yA
Manufactured
Trusses:
Sump Pump:
/"
-y-~
_Y~N
Lot Split:
DE lT~:f1'!'P(:t,"fMfIj;UNITY SERVICES
,1 I ^
PLUMBING' CONT~ef}\NA
01\.
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST&_BEAM_:PIER/
o SLAB BASEMENT (WALKOUT:_Y~ '
Fo,: Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is valid only if construction commences within 180
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
strUcrure permirs 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
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structur~s
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmellndiana - 1993"I(Z,
289) and amen ents, adopted under authority of l.c. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath n floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certifica.te of
Occul;ancy enssue by tlj~ Department of Community Semees. r:.;;~ 'DEi f\l ES '-1_ 2/.p-tJ 7
si' re of Owner or Authorized Agent Print Date
OFFICE USE ONLY: ********* *************************************************?1'f*******************
INSPECTIONS REQUIRED: Filing Fees: 13J; j21fJo
Base Inspections: __
Upper Footing Lower Footing Under Slab
Cert. of Occupancy: 5S': G (f
.....-1loiI~ Meter BaseCFinal y
~ P.RJ.F.;
5""-5- 07
ommunity Services (Date)
Revi
Fee Received by;
# Charged Re-
Reviews
Additional Fees
Date