HomeMy WebLinkAbout07050273 Application
City of Carmel/Clay Township Permit # :..Qj () 5 8 j. 73
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
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BUILDER
OF
RECORD:
NAME:
STREET ADDRESS:
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PROPERTY
. OWNER:
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FAX:
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PHONE: '1 Q
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BEST METHOD OF CONTACT:
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ZIP:
FAX:
STREET ADDRESS: CITY:
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TYPE OF IMPROVEMENT:
o I1EW STRUCTURE
rQ.;1i.bOM ADDITION(S) ~1'b
o PORCH ADDITION(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING 0 International Residential Code w/Indiana Amendments
o DETACHED GARAGE .' .
g ~~:;~~o~ARA~~~J.~ UnIform PlumbIng Code w/Indlana Amendments
PROJECT INFORMATION: /riJ/lciP;,l , (,-,.1 OUNDATION TYPE: (Check all that apply for the new
Early Release ~ Manufactured V.... construction area)
Permit: _Y _N /-Trusses: _Y _N . 0 CRAWLSPACE 0 POST & BEAM _PIER
Lot Split: _Y ~ Sump Pump: _Y _ r."It... IIY'SLAB 0 BASEMENT (WAlKOUT:_Y_N)
LOCATION
& PROJECT
INFO:
SUBDIVISION NAME:
. l(....-c T ~ )@;J>
ADDRESS OF CONSTRUCTION:
S"A ':.~?
LOT #:
\'
SEWER UTILITY
PROVIDER:
o~
WATER UTI
PROVIDER:
NAME OF lJTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I aZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
TYPE OF CONSTRU
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
I'hoO....
S-J
SQUARE ?-1 r
FOOTAGE: ~-=>
ESTIMATED COST OF CONSTRUjylON:
(EXCLUDING LANOVALUE) J(?-I 5'/{p/'" _ ",
rr-' I<~ n \\,! IF'' \'C~\ \
ICI'" ~ (C:7 \c~: II "!!~\\ \\\\
1\\ \ 1__.. _"<___- - \, \
TAX MAP PARd~45~ \ \ I \
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PLUMBING CONTRA~O~! ~ ~ \
Plumber's Indiana Sta ====:=-.J
Which plumbing codes will be applied to the construction:
For Single Family and Two Family dwellings. additions, remodels, and/or accessory structures, this pemtit 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 18 months of the issuance date. Class I
sUUcture 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 confonn to, all applicable laws of the State of Indiana, and the ~Zoning Ordinance of Cannel 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 floo ns are conn cted to the samtary sewer I further certIfy that the constructIon will not be used or occupIed until a Certificate of
---
Occupancyh.. edb artmentofCommurutYSefVlCe"~b:-::L- f6ft-C?'- Y7 //, 7
Signature of Print' Date .
OFFICE USE ONLY: *****~*******~***_***************************************** *~"******************
-r VD2.IF~ ~IS\)N~ ~...'i'S - Filing Fees' , .:0 u
INSPECTIONS REQUIR60: .
C IJp.;er-FOO~ Lower Footing Under Slab Base Inspections: /7 oz. s..-o
C ' ~ ') Cert. of Occupancy: S-J: )0
ROu9h~ Meter Base 'Final 'S.iJ:e'"
P,R.I.F,:
# Charged Re'
Reviews
Additional Fees
6 -5 -07
ept of Community Services (Date)
SIDENTlAL
TOTAL:
~~~
-$ 50S-: rv
-r LJ I I D7
Date
J.