HomeMy WebLinkAbout07060100 Application
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City of Carmel/Clay Township Permit #:~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
FAX:
Dt:SIC(i>4
STREET ADDRESS:
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PHONE:
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BUILDER
OF
RECORD:
NAME: C,(
BUILDER'S EMAIL ADDRESS: I
C j, a I'I-e
PROPERTY
OWNER:
f-e, If u Q
J ,k\..( L L ~ uC
NAME: J f. ef.
STREET ADDRESS:
0'1 M t:f..xe~
P'l7-Ul.(,
STATE:
f'tIvlS / IJ
ZIP:
<..({,z.,<l
BEST METHOD OF CONTACT:
drll.c.dl Lt09-IL76
PHONE: FAX:
7{(}-7)7{
,....
LOCATION
&. PROJECT
INFO:
LOT #:
SUBDIVISION NAME:
7fwJ JEJ..RCLAVC
:2-
.
ADDRESS OF CONSTRUCTION:
~o M
rmd
STATE:
ZIP:
'-If:,
L
N([./..
SECTION:
ZONING:-":'R'?
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" " 1
. . . ~ .. , . _ ~ J:
of' C
SQUARE
FOOTAGE:
1'16
o CRAWLSPACE ~. . POI~ST~ &'TlN BEAM _PIER
~B4'O\1\=Clj).~~~B--Y.,--N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory stStitJ~\~Q ~ l~~ . d. ~l(!*-~Q1ICtion commences within ISO
days of the date of issuance of the building pennit, and must be completed (Certificate of bccu~a~&" .hhn: m-m~d"'tt~1mce date. Class I
structure permits are subject to the General Administrative Rules of the St.ate of Indi~<<Af~~~~~r~tib?ft-Jrle"f}an ~ginning and
completmgconstru t"' I r.\.AY TOW
I, the nndersigned, agree that any construction, reconstruction, enlargement, relocation, ~iftt\pl GAiR.M~\...ai1y't11ange in the use ofIand or structures
requested by this apphcation will comply with, c fann to, all applicable laws of the W.'o~In1frana, and the Jt.e~ance of Cannel Indiana - 1993" (Z~
289) and amendments, adopted u r a . of 6~7 et seq, General Assembly of the State of Indiana, and al Acts amendatory thereto. I further certify that only
kirch, h, and drains c ect to Itary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Dc 'Pan Community Services, Carmel, Indiana.
~ C jjU-,JS (, II rI7
Si ..-~""""""Piint Date
OFFICE USE ONLY: ****** **********>*W*61.** **Jd.*~~* **************7* *****;;z* *** ****************
INSPECTIONS REQUIRED: V / (l..............Fllmg Fees: , 3 g . V
. . _~ Base Inspections: / / ,<). 0 () # Charged Re-
Upper Footmg Lower Footmg Under Slab . ReViews
. . ~~ Cert.ofOccupancy: ,").5. .)'0
(Rough In ) Meter Base ("final Site
~ '-....... _ P.R.I.F.: . Additional Fees
11 ' ~ r//':J Dr. do
LI(O-:a. nlO ( b-l~-()7. 'O'.d?/~T~~,<? Ii.
Reviewed/Appll:lVed: Dept. of Community Services (Date) ~ ,~~
SEWER UTIlITY
PROVUlER:--- "-
.........
NAME OF UTILITY EXCAVATION CONTRACTO ; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
FLOOD ZONE AREA DESIG~~TIpN(S)
FOR THIS PROPERTY: .~
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
~INGLE FAMILY \. -,nq 0 NEW STRUCTURE
o TOWN HOME (.,n2.l'l \...., 0 ROOM ADDITION(S)
o TWOFAMILY ~ J 1v 0 PORCHADDmON(S)
# of units being ~~ A e) 0 DECK ADDITION(S)
c.onstructed at this f",R- V rn-"REMODEL
time: rl'l~ Basement Finish onry
o RESIDENTIAL (For l;A 0 ACCESSORY BUILDING
Additions. Remodels. Etc.) 0 DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
PROJECT INFORMATION:
Early Release V Manufactured
Permit: _Y -+N //Trusses:
Lot Split: _Y ~ Sump Pump:
,~
_Y~
_Y_N
ESTIMATED O?SI OF_CONSTRUcnO.l'~ti "c,
(EXCLUDINGiLA,N?\V~LUE) ~2\'IGJo-;:~. ::
1'1 L,Ii [ ------:11 : )'
Ilr\1' IIi .
TAX Mf.:1 PARCEL#. 1 1 2007 ! i! ! i I
i U LlI 111)1/
, J~I
PLUMBING CONTRACTOR:
L. dW-. I
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
o International Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments '
FOUNDATION TYPE: (Check all that apply for the new
construction area)
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S:Pennits/FormsfILP RESIDENTIAL
Fee Received by:
Date