HomeMy WebLinkAbout07050255 Application
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City ofCarme//Clay Township Permit #: D 7fJ.5 fJ255
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & T~Al&1Jt.lOfIl0$tructures, Additions, Remodels, & Accessory Structures
NAME I 5 OWONE FAX
BUILDER of
RECORD:
STREET ADDRESS
STATE
ZIP
Indianapolis, IN 46'2"50
X Manufactured"
Y N Trusses: ...flY N
- - 'i. 0 CRAWLSPACE 0 POST & BEAM
Lot Split: _Y ---2CN Sump Pump: _Y -L:o-N r.%- SLAB 0 BASEMENT
Does any part of the property lie within a special Flood -/!llf~ rea: _ Y LN WALKOUT:_ Y_N
For Single Family and Two Family dwellings, additions, remodels, and ~tr!c!tQsOonrnlur ,QNS~ip,xilid only if construction com!nences
within 180 days of the date of issuance of the building permit, anilJw~[ beO$r;8r)s#a ~ffi~~>I~c~f~~d) within 18 months of the
issuance date. Class I structure permits are subject to the General ~1fJ-5p:e,(ufe ~f 00litt1tffl6Az~ lAC 12) regarding expiration
time frames for b~ compl'~M9-~d19des. S
I, the undersigned, agree that any construction, reconstruction, enl~ge~n~~HG~"'Ji~eia'i'1bHIol <Y5gf.fPkW.5hange in the use of land Of
structures requested by this application \",ill comply with, and conform to, all applicable H.{~t,{ ih~V'f Lah~/~ ~~oning Ordinance of Carmel
Indiana - 1993" (Z~ 289) and amendments, adopted under authority of LC. 36~7 ct seq. GeJANYt" y 0'[ t ljlpJj, and all Acts amendatory
thereto. I further certify that only kitchen. bath, and floor drains are connected to the sanitary se\\ e. further certi y t {ltT"e construction will not be
used r occupied until a . ertillcatc of Occupa.ncy has been issued by the Department of Community Services, Carmel, Indiana.
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Sign ture f 0 ner r Authori ed Ag nt Print
PROPERTY
OWNER:
NAME
STREET ADDRESS
LOCATION
& PROJECT
INFO:
WATER l/TlLm 17 ') J. rVl . t!
PROVIDER: LLVU I /....V.-
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE{S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
00 TOWN HOME
b TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
~.
o
o
o
o
o
o
NEW STRUCTURE
ROOM ADDITJON(S)
PORCH ADDfTION(S)
REMODEL
ACCESSORY BUILDING
DETACHED GARAGE
ATTACHED GARAGE
DEMOLITION
PROJECT INFORMATION:
Early Release
Permit:
PHONE
FAX
cm
STATE
ZIP
ZONING:
SQUARE
FOOTAGE:
tJk!&L - liW / h1I7C1Ji
PLUMBING CONTRACTOR:
~T LJTjXJILL
Plumbe s Indiana State License #:
/iJ!JaJrl'f7
Which plumbing codes will be applied to the construction:
j(J International Residential Code w /Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family ConstructIon Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
5-).~-07
Date
OFFICEUSEONLY:********************************************~*******~~****************
Filing Fees: &- 3;;' , u U
NSPECTlONS REQUI . /) <;:. r7, ",,#1
Base Inspections: -A .v L. .;..; (;L
Cert. of Occupancy: ,,,\,,) ')0
f)~1 .00
_~ 050~. 00
~ TOTAL:
Fee Received by: ~
P.R.I.F.:
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Reviewed/Approved: Dept. of Community Services
S;Permits/FormsjILP RESIDENTIAL
(Date)
# Charged Re-
Reviews
Additional Fees