HomeMy WebLinkAbout07050157 Application
City of Carmel/Clay Township Permit #: 07050157
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
BUILDER of
RECORD:
NAME \
New Structures, Additions, Remodels, & Accessory Structures
I
PHONE ~L " ZY'
~
For Single Family, Multi-Family, & Two Family:
NAME
STREET ADDRESS
CITY
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i i 1--') I STATE ZIPI i I i 'i
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PROPERTY
OWNER:
SEWER UTILITY
PROVIDER:
LOT # ,.q SUBDIVISION NAME
ADDRESS OF CONSTRUCTlON ) ~St.{J
WATER UTILITY
PROVIDER:
ESTIMATED COST OF CQNSTRUcnON:
(EXCLUDING LAND VALUE)
LOCATION
& PROJECT
INFO:
NAME OF UTIUlY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
~\
0-"
15'-1
TYPE OF IMPROVEMENT: PLUMBING CONTRA R:
~NEW STRUCTURE ~ (' ~
o ROOM ADDITION(S) Plumber's Indiana Stat>>iceq tf
o PORCH ADDITION(S) 1 fY(; 110 ~
o REMODELIiELE:~ '
o ACCESSdif.tr~~ F, hich plumbillQ codes will be applied to the construction:
o DETACHED GARA, ;:Drr,Of.' , ,"f'~pal Residential Code w/Indiana Amendments
o ATTAC~6~~h', r.f; II" I-lllC'","
o DEM""JjfJON' 0,<: .~"; an,' 0 Iror"l,!fJ.u1l11lift'~e w/Indiana Amendments
""'t1TOF (;GM^A C(VIWttfaffi,!VilIJlalf/:l ' n Code)
PROJECT INFORMATION: CAA~,f "'UN~ es. S,
Early Release ~ Manufactured / 'J ,CL !f~it~,~E: , (Check all that apply for the new
Permit: y N Trusses: ~,N ND/Ao m~<j'~i:S ;
. ~ ~ ./ - ~ CRAW"L5rJAWilfJP 0 POST & BEAM
LotSpht: _Y _N Sump Pump: ~Y _N 0 SLAB 'frBASEMENT
Does any part of the property lie within a special Flood designation area: _ Y ~N WALKOUT:_ Y ~
F ON R ION:
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
MULTI-FAMILY
# of Units:
RESIDENTIAL (For
Additions, Remodels, Etc.)
o
o
For 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, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of lanq or
structures requested by this application \vill 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 I.c. 36-7 et seq, Gmeral Assembly of the State of Indiana, and all Acts amendatory
thereto I further certIfy that only kitchen, bath and floor drams are connected to the samtar)' sewer I further certify that the constructIon WIll not be
used or upled untIl a Cer ateof, ccupancyhas been Issued by the De .rtment ofCu Unlt~ etvICes, Carmel, Indian. Alii 6 '7
Signatu", of Own pdnt . Datef, ,
OFFICEUSEONLY:*********************************************~**~*********************
Filing Fees: LZ) / ()
NSPECTIONS REQUIRED: _ J i? r"J_ ~() # Ch,arged Re-
Base Inspections: , :L. D.L oJ
L wer Foo ng Under Slab .-- ReViews
~ ~ Cert. of Occupancy: S-J' ,~tJ
inal Si P.R.I.F.: _ {; 0 Additional Fees
tJJL- ~ ~T~T;L: c)~tt /~
Reviewed/Approved: Dept. of Community Services (Date)
S:Permits/FormslILP RESIDENTIAL Fee Received by: