HomeMy WebLinkAbout07050103 Application
City of Carmel/Clay Township Permit #: 0 70S'01D3
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
,
For Single Family, Town Home, &; Two Family: New Structures, Additions, Remodels, &; Accessory Structures
BUILDER
OF
RECORD:
NAME:
PROPERTY
OWNER:
LOCATION
&; PROJECT
INFO:
SEWER UTIUTY
PROVIDER:
WATER LfTIllTY
PROVIDER:
N
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. "CHI'P
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I
FAX:
(.31
'i?
cm:
ItJb;
STATE:
IN
ZIP:
<{Ic~?'i?
SECTION:
ZONING:
$-
SQUARE
FOOTAGE: 7
ESTIMATED COST OF CONSjJ.UCTION:
(EXCLUDING lAND VALUE) fI> ~9 00
NAME OF UTILITY EXCAVATION CONTRACTOR; PlAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE): 'J
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
+ .-- ~_. --' ": ,. ',' \\1
For Single Family and Two Family dwellings, additions. remodels, and/or accessory structures, this permit is vilid-only,jf~onstiuction cOnUnences within 180
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy issued) ~~IU!t, 1(~.2~ths of the is~uan-ce-dat~), '41..si,1
structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding:,dpiration time frames for beginn!~g k).~
completing construction. '\ \.:: / \ (\nl \ 'J \ \ 1\
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, o[\~n.) ~r~nge 4:Ath~'use\of 4nd?'or.structu,re. ~ l \
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the ~Zoni~g q~dinan&\!;f Carmel Indiana - 1993~1,['0
289) and amendments, adopted under authority of I.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 us'ed'oroccupieduntilaCertificat~ of '\
Occup'ancyhas been issued by the Departme?t of Conununity Services, Cannel, Indiana. \ ' ~
. B' - koR.; A. 6;RhSONcs.-J.lENJ;Alf---~'-5JI/7tJ7 I
Signature of Owner or Authorized A ent Print Date I
I
OFFICE USE ONLY: ****** ******* ** ***************~~******.*************j*;*J !;** *j'O****************I** ***
INSPECTIONS REQUIRED: FIling Fees. /.Lif. ,
Base Inspections: d J' '7. ,fJ # Charged Re-
ReViews
Cert. of Occupancy: 0"'l': rfj
P.R.I.F,: / J. 6/, {)() Additional Fees
TOTAL: ,,fc2? sex. /()
TYPE OF CONSTRUCTION:
I'll' SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
_Y ~~
_Y~N
Early Release
Permit:
Lot Split:
TYPE OF IMPROVEMENT:
~NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
Sump Pump:
-4-~'
LY_N
Reviewed/
S:PermitsjFormsjIlP RESIDENTIAL
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'l...
TAX MAP PARCEL #:
PLUMBING CONTRACTOR:
PAIJ..I f.S",,;n-l
Plumber's Indiana State License #:
101777
Whi~ILlmbing codes will be applied to the construction:
at" International Residential Code w/Indiana Amend~ents
,
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the!new
construction area)
o CRAWLSPACE 0 POST & BEAM _)JER
o SLAB ~ASEMENT(WALKOUT:_Y <,N)
. -,."
Fee Received by;
Date