HomeMy WebLinkAbout07070075 Application
City of Carmel/Clay Township Permit #:!37D7oory5
RESIDENTIAL Il\1PROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
NAME:
PHONE:
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FAX:
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STREET ADDRESS'
02..)
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CITY:
itA.
STATE:
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ZIP:
(f< z.. ()
PROPERTY
OWNER:
BEST METHOD OF CONTACT:
,c.
PHONE:
FAX:
STREET ADDRESS:
CITY:
STATE:
ZIP:
LOCATION
& PROJECT
INFO:
lOT #:
2/0 SUBDIVISION NAME: /"'
ct
'(/.......~
SECTION: y
ZONING: s--
ADDRESS OF CONSTRUCTION: '39 2 'i
tJ () I" "
SQUARE ?
~ FOOTAGE: ./ '11:>
ESTIMA COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) ...,. - ,~
~ 1(/ ~o
SEWER UTILITY WATER UTILITY /'
PROVIOER: C' T;<: hi tJ PROVIOER: L., A po... <-
NAME OF lITlLITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET ::U=:
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TAX MAP PARCEL #:
C.
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR: 1'0,. A ~Ite
O/SINGLE FAMILY [j...jqEW STRUCTURE E. L? 0,. ~" :Ill 8~ ,0/,,-
o TOWN HOME 0 ROOM ADDITION(S) Plumlier':~iana State ~:;t.e #: Ct @ 8. ~
o TWO FAMILY 0 PORCH ADDmON(S) Os' .,
# of units being 0 DECK ADDmON(S) 1& 5- 'tel'! '~J~6
constructed at this 0 REMODEL I
time: F' . h I Which plumbing codes will be applied to the construction:
tE~ent InIS on y
o RESIDENTIAL (For 0 ' ~ ~DING CJ.<ntemational Residential Code w/Indiana Amendments
Additions. Remodels. Etc.) 0 e~P.:G b
o ATTACH tyG~ "CON 0 Uniform Plumbing Code w/Indiana Amendments
o ~QL 1...."1 IlI1Ca ' Sr~1 'Gl<lmI\; I
PROJECT INFORMATION: C/~~~ OF~<u. iii IInct (0 iNlli) all ~ f'9,str.u~iON TYPE: (Check all that apply for the new
Early Release ~ Man\Jf~". Co M/" r;a/ COde i(i}V(tfflol1S area) I
Permit: _Y ~N/ Trusses: "i'\ t:irV/Ty SE s. 0 CRAWLSPACE 0 POST & BEAM _fIER
Lot Split: Y ~ Sump Pump: Ql.4 y r. RI;/C~B 8""1lASEMENT (WALKOUT:~Y~:._
, 0 \ " . '.d~ I
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, t ermit is valid 6JIY1f-cbftstrik~nl~o~e~~~~ Wi~hin1180 '\\
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) withi41.8~rh9ilths ~fthe i;stiancedate."~Ciasls\l \ ':
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expira'tion time frames for beginning ~' d
. . completing c~nstruction. . \ \ r<' \. I)(\rrl \! ~
I, the underSIgned, agree that any construction, reconstruction, enlargement, relocation, or alteratIOn of a sttucture, or anYiqhange In r!1dUtpf llndhr ~ures I
requested by this application will comply with, and conform to, all applicable laws of the Stare of Indiana, and the "Zoning Otdina~ce of Carmel Indiana - 1993" (Z~l L
289) and amendments, adopted under authority of I.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amJridJtbb thereto. I further cer~ify.tW~y
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be usea or oc5rpiedUIiill a Certificate of
Occupancy has been issued the Department of Comrnuruty ServIces, Carmel, Indiana L
-X ~~ (. ?OAIf ~e:. 7-'7 -fJ7
pnnt Date
51.
OFFICE USE ONLY: ************* ************************************** *?f':* ***************************
INSPECTIONS REQUIRED: Filing Fees: '7"9' ~ J () !
U Base Inspections: ) [(7. )'/J # Charged Reo
Slab ReViews
Cert. of Occupancy: SO;-, )"rJ
Site
P.R.I.F.:
/ ;) t, I /J 0 Additional Fees
TOTAL: ' . ;9;;<3 1'1. .~ QJ
(Date)
S:Permlts/FolTT1s!IlP RESIDENTIAL
Fee Received by:
Date