HomeMy WebLinkAbout07050042 Application
City of Carmel/Clay Township Permit #:D705~rif~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Str~ctures
BEST METHOD OF CONTACT:
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D~G PHONEj>L{.-f_S3'C6
STREETAOORESS.5;>lc &ner.3J~KJ cm:ta./rne:..-l
SUBDIVISION NAME:
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BUILDER
OF
RECORD:
NAME:
PROPERTY
OWNER:
LOT#:
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FAX:
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FAX:
STA7t\J
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LOCATION
&. PROJECT
INFO: ADDRESSOF~trY\ QJ
SEWER lJTILITY WATER lJTI
PROVIDER: (J!r I'h-( I PROVIDER:
NAME OF UTIlITY EXCAVATION CONTRACTOR; PlAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DAlE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
:::.\
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
)l!t SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
~ RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
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- y ----aD
_ZONING:
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TYPE OF IMPROVEMENT:
o NEW STRUCTURE
~ ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
~ ATTACHED GARAGE
o DEMOLITION
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t......... ~.....-=--- ...-:---, f1 V\ .. ;-_~;".1 ~..-...
Manufactured
Trusses:
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- y ----'fl)
TAX MAP PAR,C,E,l/i:~ ~-fl l~})_i \~i (_:', I: ), \
, , 'fiN" 5~i::r'f:;(f.:(-~i.i
PLUMBING CONTRACrrOR' I! i ill!
tJ/A illl\! r-:: o~LJ)i
Plumber's Indiana ffate License.#:- - - ._~:? i
I '
Which plumbing COdeS-~i11 be a~pli~ to the construction: - I
o International Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments I
FOUNDATION TYPE: (Check all that apply for thelnew
construction area)
o CRAWLSPACE 0 POST & BEAM ~PIER
~ SLAB 0 BASEMENT (WALKOUT:_ Y ~N )
Sump Pump:
Foe Single Family and Two Family dwellings, additions. remodels, and/or accessory structures, this permit is valid only if construction commences within 180
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure permits 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, reconstru~ enlargement, relocation, or ~Jteratjon of a structure, or any change in the use of land or structury:s
requested by this application will comply with, and ~form to, all applicable laws of the State of Indiana, and the KZoning Ordinance of Cannel Indiana -1993nl(Z~
289) and amendments, adopted under authonty 9f1 C 36~7 et seq, General A""Sseo::!:bly of the State of Indiana, and all Acts amendatory thereto I further certify that only
kItchen, b h, and floor drams are co ted 7fhe samtary i:ewer I further certl that the constructIOn will not be used or occupied until a Certificate of
Qccu yha~ been IS ed, par ent 0 fa~ ty \lV1ces, eel, ndlana -"
l . ~~' ~.~-o7
D.te
******** ******
INSPECTIONS REQ ~J ~ )>
~ FOO~ Lower Footing Under lab
~ Meter Base
Reviewe
***7 *************************~*********************
Filing Fees: / ;72 U
/'1;r SO
.
5 J J-d
Base Inspections:
Cert. of Occupancy:
# Charged Re.
Reviews
P.R.I.F,:
#. Additional Fees
o o.-()~
TOTAL:
Fee ReceIved by:
Date