HomeMy WebLinkAbout07050135 Application
City of Carmel/Clay Township Permit #: 0'7050135"'
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, 8< Two Family: New Structures, Additions, Remodels, 8< Accessory Structures
PHONE:
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cm:
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FAX:
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BUILDER
OF
RECORD:
NAME:
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STREET ADDRESS:
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BUILDER'S EMAIL ADDRESS:
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STATE:
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ZIP:
~ \,60'1-
BEST METHOD OF CONTACT:
PROPERTY
OWNER:
NAME:
L"'l'r") \C.~:~
STREET ADDRESS:
2 '6"0"1 b.q~\\.. ~\
LOCATION'
8< PROJECT
INFO:
SEWER LfTlLITY
PROVIDER:
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.'----\ ,'!'-:-1/?;,
. 'r', _ .-:::;1!. _
SQUARE
FOOTAGE:
WATER lJT1llTY
PROVIDER:
I,: !ESTIMATID COST OF CONSTRUCTION: !
'I. : (ExCLUDING LAND VALUE) 1"I/O<lO
I ,,<.., 1 I:
1,\1 MAY 1 "I
, I
NAME OF llTlLITY EXCAVATION CONTRAanR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
o NEW STRUCTURE
o ROOM ADDITION(S)
Jl'5. PORCH ADDmON(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
PROJECT INFORMATION: ;:;/ DEMOLITION /
Early Release AI /Manufactured ~ ./
Permit: _Y ~ Trusses: _Y ~
Lot Split: _Y ----t:;N Sump Pump: _Y _N
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions, Remodels. Etc,)
TAX MAP PARCEL #:
TYPE OF IMPROVEMENT:
PLUMBING CONTRACTOR:
I!//l
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
o International Residential Code w/Indiana Amendments
o Uniform Plumbing Code wjIndiana Amendments
FOUNDATION TYP .~ (Check all that apply for the new
construction area
o POST &
BEAM _PIER
o BASEMENT (WAlKOLrr:_Y_N )
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 land or structures
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the aZoning Ordinance of Carmel Indiana - 1993" (Z'
289) and amendments, adopted under authority of LC. 3~7Aet-secj,Gener,~j 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 silnitary sewer. 1 furt . r certify that the construction will not be used or occupied until a Certificate of
Occupancyhas been issued by the Department,o( commu~ty ervi~ armel, Indiana.
S':::':f Owne, 0' A" /!::> J-- P,in \ YV\ ~"'"" :filr6/
L F t' U d SI b Base Inspections: /?.;z s1J
ower 00 '"g n er a 0
~ ~ Cert. of Occupancy: ~- 5. )I
cinal Site
P'R'I.F'~'
..zJ-07 OT: Iii ~ g 3_
Oily Services (Date) '0 ~~"-
Fee Received by: /
Revi
S:PermltsjFormsjILP RESIDENTIAL
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# Charged Re-
Reviews
Additional Fees
?cf
Date