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HomeMy WebLinkAbout07050110 Application City of Carmel/Clay Township Permit #: ()7050110 RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures BUILDER OF RECORD: t)~-H0 PROPERTY OWNER: STREET ADDRESS: FAX: 311-. STATE) ~ dP: BEST METHOD OF CONTACT: lh15V-- "1-7~lg 1rg PHONE: FAX: CITY: ZIP: STATE: LOCATION & PROJECT INFO: LOT#: 410 ,A;~3F c;0'" SEWER UTIL PROVIDER: NAME OF lfTlLITY EXCAVATION CONTRAerOR; PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE): FLOOD ZONE AREA DESIGNATION(S) FOR THIS PROPERTY; TYPE OF CONSTRUCTION: TYPE-OF IMPROVEMENT: qt SINGLE FAMILY r1 NEW STRUCTURE It! TOWN HOME 0 ROOM ADDITION(S) o TWO FAMILY 0 PORCH ADDmON(S) # of unit/i,l>,eioQ " ..Q.. Q~c;IU\q!lPWtt(S) construa&klHhiSED FOR '-Si~!tEMGDEL____1 ;,,)1'\) time: Subiect to comoli<1nce with11IBasetrielJtJ'inish only o RESI?ENTlAL (Foro! State and ll6C<1~g;;R!;,s9RY BUILDING AdditiOns~'er!'~'()iV1M~ l"f~~i~~~g:~i PROJECT I~bX~~i61' " EL /IQI.Jl.riM91:!li~~SHIP Early Release }~Dlf.lhWactured /, Permit: y - . Trusses: Y _1)10- Lot Split: _Y ~N " Sump Pump: _Y --=::::-N SEmON: ZONING: VLt D ~g~:~E 1- q 't 1i 'LtCi ~ tBWaL -t11'\ I ESTIMATED COST OF CONSTRUrnON: (EXCLUDING LAND VALUE) JbH- TAX MAP PARCEL #: PLUMBING CONTRACTOR: V~ULe S1Yl \ 1\-\ Plumber's Indiana State License #: __-.:-~----- .---;.:" \ J' ....,< .,,[1 \~ 01 I I /~\\~J_.; , _,/,--<;::::, !( rl \.~~ Whio/Plumbing codes will be applied tothe,CC?nstruction: ~Intemational ResidentiarCo\\~~;~diana AI1]enctli1ents " li\ \!-0' o Uniform Plumbing Code w/](I~iana ~nJ.nents \\\ \\\ - ~/ FOUNDATION TYPE: (CheCk al"that apply.fOr the new constr~;::~PACE ~\P~~~:A~IER 0' SLAB 0 BASEMENT(WALKOUT:_Y_N) For Single Family and T WQ Family dwellings. additions, remodels, and/or accessory structures, this permit is valid only if construction conunences 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 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, re.constructi.on, enlargement, relocation, or alteration of a structure, or any change in the use or 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 Cannel Indiana -1993" (Z~ 289) and amendments, adopted under authority of r.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify th.at only kitchen, bath, and floor dra. s e connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of Dc anc~t b:e~i"u d by the Dep.artment 01 Community SeMc,", m:tJ~c'SL{, Esp I r I +~.'- S /4 J D Signature of Owne. o. Authori,'" Print Oate ' 7 OFFICE USE ONLY: ************* ** ****************************************** ********************* *** J:C;~ONS REQUIRED: b~,;Filing Fees: . I-J V :::? , CZ" {! ~ F t~ L F t' d SI b Base Inspections: ;} ~ 7. <) 0 per oo~ing ower 00 Ing n er a . r- "" Cert of Occupancy: S.:>, -.J 0 / ~~I 0 V o {fl tp P.R,LF.: # Charged Re- Revj~ws Additional Fees S:Permits/FormsjILP RESIDENTIAL