HomeMy WebLinkAbout07050257 Application
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Ctty ofCarmd;-ei;;'TJwnshtp Permit #. /U ,)1) 207
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICAIfION
I
For Single Family, Town Home, &. TwO!mi: ~.ctures, Additions, Remodels, &. Accessory Structures
NAME: annon Ins EftWlE: FAX:
I
I
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
STREET ADDRESS:
STATE:
ZIP:
Indianapolis, IN ~50
NAME:
STREET ADDRESS:
SEWER UTlun /7 () u TV1 A II
PROVIDER: LWU I Lf-L
WATER UTILITY /1/1. I rv1 II J
PROVIDER: Li1utJ 1l.J:...-K-.-
PHONE:
FAX:
CITY:
SlATE:
ZIP:
ZONING:
~g~~~E: ~ 7 LIS-
ON:
.1 / /
tJ4f!l!lL- (J/-W71dJ7Ct}in
NAME OF UTILITY EXCAVATION CONTRACTOR; PlAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABlE):
FLOOD ZONE AREA DESIGNATlON(S}
FOR THIS PROPERTY:
TYPE OF CONSTRUcnON:
p SINGLE FAMILY
jlfJ TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
Y X N
Y XN
TYPE OF IMPROVEMENT:
[j NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATIACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
Sump Pump:
'/...Y_N
_Y+N
TAX MAP PARCEL #:
PL~ING CONTRACTOR:
T Lfr/JOJ!--L
Plum er's Indiana State License #:
/O/),OCVJ57
Which plumbing codes will be applied to the construction:
~ International Residential Code wI Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM _PIER
\.li( SLAB 0 BASEMENT (WALKOUT:_Y_N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is valid only if construction commences within ISO
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy issued) within IS 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
l:ompleting 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 "Zoning Ordinance of Carmel Indiana -1993" (Z-
289) and amendments, adopted under authority of LC. 36~7 et seq, General 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 sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occ ancyhas been issued by the Department of Corrununity Services, Cannel, Indiana.
, .LI./ \ qf/liA/A/ON l-trrYSHfJ/AJ
Signa re of n r or Au orized Agent Print
OFFICEUSEONLY:******************************~~*********************~*************************
~PECTIONS REQUIRED" Filing Fees: W '8, ,~7)
Clipper F~~9 Lower Footing G~der s;a~ Base Inspections: '2~--i: ,t)~
C:,ji,"w:"~~ ~ ~:;:."'""OCY' $JS:O~
tG1~ ~ ~TOTAL: 5t 5 If?;. 5'tJ
Reviewed/Approved: Dept. of Community Services (Date)
S,Pe'm;~/Fo'm'/ILP RESIDENTIAL Fee eceived by: . Date
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# Charged Re-
Reviews
Additional Fees