HomeMy WebLinkAbout07060165 Application
City of Carmel! Clay Township Permit #: 07 O(pf) I /pS-
I
RESIDENTIAL IMPROVEMENT LOCA'FION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures: Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
STREET ADDRESS
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PHONE 8 <t6- 2<.i{2- FAX jY(-l(uy
STATE ZIP
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BEST METHOD OF CONTACT:
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PHONE FAX
CITY STATE ZIP
NAME
PROPERTY
OWNER:
NAME
SUBDIVISION NAME
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ADDRESS OF CONSTRUCTION : : i j) I I ~ : SQUARE
...., '-6. r; I ~\<\ I ,II ilFOOTAGE
~ .J ;:> , .' '}l\f\7 II
SEWER UTILITY WATER UTILITY . llJ \ ESTIMATED COST OF CONSTRurnON:i i
PROVIDER: C T j( IJ t:>.. PROVIDER: C..... k n e i ' .' ECLUOING LANO VALUE) J L::::.:2 7 ()
NAME OF umLITY EXCAVATION CONTRACTOR; PLAN COMMISSION I SZA I SPW OOCKET I ~ . Q I J'
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR C PERMIT #'5 (IF APPLICABLE)'
LOCATION
& PROJECT
INFO:
lOT # G
l?'f
SECTION
ZONING:
,~
/t r)
ViJq
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TYPE OF CONSTRUCTION:
rg/$INGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Manufactured /
_Y _N Trusses: ~ ~N
~ 0 CRAWLSPACE
Lot Split: _Y _N Sump Pump: _Y _N GJ-SLAB
Does any part of the property lie within a special Flood designation area: _Y_N
Early Release
Permit:
o POST & BEAM
s-liASEMENT
WALKOUT:_ Y ~
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences
vvithin ISO days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months ofrhe
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 w1(h, and conform to, all applicable laws of the State of lndiana. and the "Zoning Ordinance of Carmel
Indiana - 1993n (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 scsvcr. I further certify that the construction will not be
used or occupied until a Cerci icacc of Occupancy has been issued by the Deparnncnt of Community Services, Carmel, Indiana.
//L ?Ract= A'- -07
prir Date
OFFICEUSEONLY:*****************************************************~******************
Filing Fees: J- 57(2 fL(J
INSPECTIONS REQUIRED: I . ~J
~ ~ ~ Base Inspections: ,;;2 (7 -? ~
Lower FOO~ Under Slab 1-1'- )()
- - _ Cert, of Occupancy:
Meter Ba /"final ~~e - I J // -}ll
J J n ~- ./" P.R.LF,: , (/\ U _U.'J J/, Additional Fees
=-c-wJJ ~ ( ~ TOTAV) ~ ,l;b-~ /-11/)0
Rev/ewedjApproved"1fept. of Community Services (Date) ~H~/ ~L
S;Permlts/Forms/llP RESIDENTIAL Fee Received bv
# Charged Re-
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