HomeMy WebLinkAbout07040159 Application
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BUILDER
Of
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INfO:
City of Carmel/Clay Township Permit #:~9
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
NAME:
PHONE:
FAX:
- UlI-OlzPl..
.s
ZIP:
<l4tJ3
i-V
STATE:
nv
&J-.4
BUILDER'S EMAIl ADDRESS:
....\l.,,'^ 1'l12e. .3-oL CD OM.-
C<!!.-II - 3/7-- Zt>/-tJ/ & r..
NAM
lod.
PHONE:
'1/ r - 84L/-DsO
Cl1Y:
C. ~/
FAX:
E.... /d0
STREET ADDRESS:
STATE:
J::;V
.ZIP:
/atJ:rz...
(tONING:)
- 51
J:ctrms
FreeholJ C+
SECTION:
SQUARE
FOOTAGE: B, '0 (i!f
'SEWER'unLl1Y
PROVIDER: Gilt
TYPE OF CONSTRU
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
1 time:
l'\( RESIDENTIAL (For
Additions. Remodels. Etc.)
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) f 2/ IJOO
TAX MAP PARCEL #:
o
o
o
o
~
o
o
o
o
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB ~ BASEMENT (WALKOUT:_Y~N )
PROJECT INFORMATION:
EOrl., Release
lp.errrift:/
----I'
IQ:?t;Sp ~
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences within ISO
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy issued) within IS months of 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 Carmel Indiana - 1993" (Z-
289) and amendments, 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, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of'
Occupancy has been issued by the Department of Community Services, Cannel, Indiana.
"E &6 S/J~er
I
/ '-.OJ ~~rlutaCSUred
y ~t\l"/ ~~sses:
_Y ~N Sump Pump:
_Y/N
LY_N
Signature of Owner or uthorized Agent
Print
oi)Z3}f
OFFICEUSEONLY:*******************************************************************************
INSPECTIONS REQUIRED: Filing Fees: /;3;? )()
Base Inspections: / / j, 0(/
~5sV
Upper Footing Lower Footing
~ Meter Base Final
~i( Ad
Reviewed/Approved: Dept. of Community Services
der Slab
Cert. of Occupancy:
Si
ditlonal Fees W.
to..-te.<:t ..f
f'eYM{l
LS~ Xi!flo1
Date
P.R.I.F.:
TOTAL:
(Date)
S:Permits!forms!ILP RESIDENTIAL
Fee Recelved by: