HomeMy WebLinkAbout07050240 Application
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.o~;1i\ if. CityofCarme//Clay Township Permit#: tJ7(J~O;NO
.:~.o RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
. '
',,0. " For Single Family, Multi-Family, &fuf!te;1:~lJm!'lSW Structures, Additions, Remodels, &. Accessory Stru!=h'res
BUILDER of
RECORD:
NAME
FAX
STREET ADDRESS
Indianapolis, IN 4625tT
ax
STATE
ZIP
PROPERTY
OWNER:
NAME
PHONE
FAX
STREET ADDRESS
cm
STATE
ZIP
LOCATION
&. PROJECT
INFO:
SEWER UTILITY t1 r1 f WATER UTILITY 11 /l J Y\/"l A J
PROVIDER: L1L/[.f/2.LL PROVIDER: ULJU I Lf-.C-
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE):
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
.~ TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units;
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
9!f. NEW STRUCTURE Li2T ~
o ROOM ADDITION(S) p~er's IndIana State LIcense #:
RECEA xa)!flCON~)
SUb~t ~~llg~~%U i. mbing codes will be applied to the construction:
DE@ 0 ~. ECOdes~~t~~ational Residential Code w IIndiana Amendm~nts
CITY eF O~~eN flffl!Y SER~orm Plumbing Code wI Indiana Amendments
"""W'I::' I CLAy TOWN ti-Family Construction Code)
INDIAN HIP
M f ct d . A FOUNDATION TYPE: (Check all that apply for the new
T anu a ure X Y N construction area)
russes: _ _
X 0 CRAWLSPACE
Lot Split: _Y..JLN Sump Pump: _Y _N '}2'l- SLAB
Does any part of the property lie within a special Flood designation area: _ Y LN
PROJECT INFORMATION:
Early Release
Permit:
_yLN
o
o
POST & BEAM
BASEMENT
WALKOUT:_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 IS 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 ~Zoning Ordinance of Carmel
Indiana - 1993~ (Z- 289) and amendments, adopted under authority of l.c. 36-7 et seq, General Assembly of the State of Indiana, and ail Acts amendatory
thereto" I further certify that only kitchen, bath, and floor drains are: connected to the sanitary se\ver. I further certify that the construction will not be
use ,or occupied until a Cert"ficate orOccup.1ncyhas been issued by the Department of Community Services, Carmel, Indiana.
. W JHRtJIJ(),,/ 1-I.1-7'JJfJf)/;j j-JB-tJ7
ner 0 Authoriz Print Date
P.R.J.F.:
OFFICE USE ONLY: *********************************************
Filing Fees:
Base Inspections;
Cert. of Occupancy;
# Charged Re-
Reviews
Additional Fees
Reviewed/Approved: pt. of Community Services (Date)
S:Permits/FormsjTLP RESIDENTIAL