HomeMy WebLinkAbout07050055 Application
City of Carmel/Clay Township Permit #: D70S0fJ::;5:
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory StrJctures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER lITILITY
PROVIDER:
B~ EMAIL Af\DRESS: ...1_ L
31\\ \'ier~<.:.JU1J6 ~5.~
NAME: t:x:l.~
NAME:
STREET ADDRESS:
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5G
FAX:
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STATE:
PHONE:
,
BEST METHOD OF CONTACT:
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CITY:
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERlY:
TYPE
F CONSTRUCTION:
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
_Y'-=--N
_Y_N
~
C:VIL-,
Reviewed/ Appr
S:Permits/Forms/ILP RESIDENTIAL
\2
WATER UTILITY
PROVIDER:
~
ADDRESS OF CONSTRUCTION:
34~
CJ\<,~
rtJ
SQUARE
FOOTAGE:
3L\~\
ESTIMATED COST OF CONSTRUcnON:
(EXCLUDING LAND VALUE)
3~K
NAME OF UTIlITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WEll AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE);
at::> 6~OC>~'i
f'\."\ C\)~
Wh~plumbing codes will be applied to the canst. '"ct. ion:
~ International Residential Code w IIndt~~,Amendments
o Uniform Plumbing Code w/Indian'l.",~~ents
. ",...;J::! ~p
FOUNDATION TYPE: (CheC~,,~PIY ~~new
construction area) ~Cj"~~~~' N"; .;s .
o CRAWLSPAgQ" 0~...~~~ _PIER
o SLAB ~~~Nfi ~~rn.O_Y~)
For Single Family and Two FamilydweJJings, additions, remOdelS"an.d!.fl~ ibc_~stfY~~~upes~~is ~~v- ~)??i~tIt1, ?~~mmences within 180
days of the date of issuance of the building pennit, and must be cOIl}P!etfd (Certificate-of Occur~~,~ ~~~! ~suance date. Class I
structure permits are subject to the General Administrative Rules of the'State of Indiana (See 67~ ~~g~l)g ~lr~ ~ rrames for beginning and
~bmpl~ting construction. c..~ j I i 110"'< ..... t,1-..<:(}. ~
I, the undersigned, agree that any construction, reconstruction, enlarg~rpep~,irelocMi&Y or..wte1flti~"Rf,a m:rJ~~u '~._., ~~\l;)lnge in tbe use of land or structures
requested by this applicatIOn will comply with, and conform to, all applicaoleilaws of'th~ State Of lndiM/a, and ,ci~Ordinance of Carmel Indiana - 1993" (Z~
289) and amendments, adopted under authority of LC. 36-7 et seq, Ge~eral A~se~bly of the State of Indiana, an, ' [~ts amendatory thereto. I further certif)lthat only
kitchen, bath, and floor drains are connected to the sanitary sewer. I ~rther certify 'iJiat"the'construction.Yh1I(!)t"'b~ used or occupied until a Certificate' of
Oeeu ;mey has been issu y the Department of Community Ser'D.~annel, Indiana. I'
.. ~ -- --- ~\.;t'1b~
Date '
Lot Split:
Signature of
TYPE OF IMPROVEMENT:
.g( NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
Manufactured
Trusses:
dY _N
'LY_N
Sump Pump:
OFFICE USE 0
INSPECTIONS REQUIRED:
~er ~<!ower-Fo~" Under Slab~
<Roun~ ~n';;l ~
TAX MAP PARCEL #:
PLUMBING CONTRACTOR:
~\€.~
Plumber's Indiana State License #:
\ ci..\\ '1
L315,50
# Charged Re-
Reviews
Filing Fees:
Base Inspections:
Cert, of Occupancy:
P,R.I.F.:
,,&1l';;r
7 ~()
)(}
iJ r 138 ,A~nal Fees
$ c2 ~:._ /()
gij . .t:O
Date