HomeMy WebLinkAbout07040230 Application
City of Carmel/Clay Township Permit #: 0101 oJr30
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
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BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER UTILITY
PROVIDER: C -r,(' (,.1 d.
NAME:
Uc;V:'5
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PHONE:
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CITY:
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FAX:
STREET ADDRESS:
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BUILDER'S EMAIL ADDRESS: (J...
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STATE:
ZIP:
NAME:
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STREET ADDRESS:
lOT #:
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SUBDIVISION NAME:
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J.,4,u ~J
PHONE:
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BESTMETfj05~6F.L.cC)NW'I: =,~~ 0-1::;' 17 ~~-' fR' "I
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I\~\I FAX: II I
I ~ I STATE: ZIP 110
ADDRESS OF CONSTRUCTION:
)s-31 /11./,", v!'.
WATER UTIlITY
PROVIDER: c..,,-.(. /
CITY:
SECTION:
ZONING:
</tl/7';
SQUARE
FOOTAGE:
3].-{2..
ESfIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) :2.",?, "c",
NAME OF LfTIlITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF IMPROVEMENT:
TYPE OF CONSTRUCTION:
-%- SINGLE FAMILY
D TOWN HOME
D TWO FAMILY
# of units being
constructed at this
time:
D RESIDENTIAL (For
Additions. Remodels. Etc.)
01'
D
D
D
D
NEW STRUCTURE
ROOM ADDrrION(S)
PORCH ADDmON(S)
DECK ADDmON(S)
REMODEL
_ Basement Finish only
D ACCESSORY BUILDING
D DETACHED GARAGE
D ATTACHED GARAGE
D DEMOLITION
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,
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TAX MAP PARCEL #:
PLUMBING CONTRACTOR:
Z I [ .<:/f.zT/,/
Plumber's Indiana State License #:
jOt7?'?
Whi}t1 plumbing <:odes will be applied to the construction: . '
CY'International Residential Code w IIndiana Amend~ents
o Uniform Plumbing Code wI Indiana Amendments I
I
FOUNDATION TYPE: (Check all that apply for the:new
Manufactured construction area) ~ I
_Y _N Trusses: ~Y _N 0 CRAWLSPACE D POS~Jl.~'\:~~,LPIER
0;,'<"' '~'a-\\ I
Lot Split: _Y _N Sump Pump: ~Y _N 0 SLAB 1:8' BASE~W~\<~~'--Y ,K' N)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this per~H~ omY:l.~~s~t&'o~~_~j:n~ esa.i.~'I80
days of the date of issuance of the building pennit, and must be completed (Certificate of Occ~!:'~t..)\1sinreC!.J~~'i8..{lff1~~~ ~tr-~~~~'class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 6~'t2l~~~~\ri.~~~~ t(~~~r beginning and
completing construction. t;..1j.'O\e 0\ CO (l~~\ ("..~. . .
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration ora srrl.Jcture~~:'t(a the"ti,E, e!. land or strl:lc.tures
requested by this application will comply with, and conform to, all apphcable laws of the State of Indiana, a!lp.._\h€\~M'i1 ce--q(~e1 Indiana - 1993" (2-
289) and amendments, adopted under authority of LC 36-7 et seq, General Assembly of the State of lndian~_a~ endat\~\+Mreto. I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the constructiO!l.~btII)e used or occupied until a Certificate of
Occu anc has been' by the Department of Community Services, Cannel, Indiana. \J
<::; ~ ,./ <:,.,..-1 i5..:"",TiI
PROJECT INFORMATION:
Early Release
Permit:
Signature of Owner or uth~zed Agent
Print
~j7J:n
Date
OFFICEUSEONLY:**************************************************************************~******
INSPECTIONS REQUIRED: Filing Fees: %'2r;l~o ' "
IIf'nn, F --~L '. F ;;V U d SI b Base Inspections: s2 '9 '7. ,)'1 # ChargedRe-
~er oo~........... ower 00 I n er a (j::; V Reviews
~ Cert, of Occupancy: ~ . Si
~OUg~ ~ ~ Si:.) P'~R'LF': _ /rJ-(,1 dO Additional Fees
( ~ OTAL:
(Date) . ~
S:PermitsjFormsjILP RESIDENTIAL
Fee Received by:
Date