HomeMy WebLinkAbout07080041 Application
City of Carmel/Clay Township Permit #: 0 7 ()~'Cf)HI
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of N~y.; I< ~~
RECORD:
STREET ADDRESS
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BUILDER'S EMAlL ADDRESS
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PROPERTY
OWNER:
NAME
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STREET ADDRESS
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LOCATION
&. PROJECT
INFO:
lOT # SUBDM$IQN NAME
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SQUARE
FOOTAGE:
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ADDRESS OF CONSTRUCTION
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PHONE
FAX
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CITY
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STATE
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ZIP
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PHONE
BEST METHOD OF CONTACT:
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FAX
CITY
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SEWER lJT1UTY
PROVIDER:
4/E-
Manufactured FOUNDATION TYPE: (Check all that apply for the' new
v V construction area)
~Y _N Trusses: _Y-A-N
I\{ 0 CRAWLSPACE
Lot Split: _Y -A-N Sump Pump: _ Y XN 0 SLAB
Does any part of the property lie within a special Flood designation area: _ Y XN
For Single Family and Two Family dwellings, additIons. remodels, and/or accessory structures~this ~ '~~ ' .
Wlthin 180 days of the date of issuance of the building permit, and must be completed (Cernflc C~~'f . ~ t(' the
issuance date. Class I structure permits are subject to the General Adnumstrative Rules of ~J ~~~~~ ~ ~~ ng expiratlon
time frames for beginnmg and completmg con~~. 0' 5 :"rl.\o!~ <:I
I, the underSIgned, agree that any construction, reconstruction, enlargement, relocation, or alteratl~~t a stru~~Q\~ee use of land or
structures requested by this application will comply WIth, and conform [0, all applicable laws of the Stat.t.~ . ~" rdinance of Carmel
Indiana -1993" (Z' 289) and amendments, adopted under authonty of I C 36,7 et seq, General Assem~~~ f Indi , and all Acts amendatory
thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. ..l\~~2ertify that the construction will not be
used or occupied until a Certifi~ of Oc~y ha.;;;4en issued by the Department of Commulluy Services, Carmel, Indiana.
C::'7 ,.P d d;:t::' ~' F /'{ V / F /:J O~/. -4 /'{# Y/7 /t!? 7
Signature of OWner 'Of Authorized Agent Print Q.(e / '
OFFICEUSEONLY:************************************************~~*~,~*****************
Filing Fees: C / ~, 1-/",-
INSPECTIONS REQUIRED: / I .....-;
Base Inspections: '7::2 . "'> (J # Charged Re-
Lower Footing Under Slab ____ ~ ~/) ReViews
~. Cert. of Occupancy: <.5 ::> . ~ 1/
Meter Base Final Site
P.R.I.F.: Additional Fees
1J!- ~7'~. ~/3-D7
Fe e ved by:
WATER lJTllITY
PROVIDER:
S T/A/G
NAME OF UTIUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
TYPE OF CONSTRUCTION:
,
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
J&. RESIDENTIAL (For ~
AdditiDns, Remodels, Etc.) .
PROJECT INFORMATION:
Early Release
Permit:
eRA\...-. HI~R-. 8-IO-D7
ReviewedjApprovE1d: Dept. of Community Services (Date)
S:Permlts/FonnS/ILP RESIDENTIAL
ESTIMATED COST OF CONSTRUcnON:
(EXClUDING LAND VALUE)
0<7
PLUMBING CONTRACTOR:
,z.E. /S{EycfstJv
Plumber's Indiana State licenSe #:
? / 0(9 Jr/ @ C
Which plumbing codes will be applied to the construction:
o Intemational Residential Code wI Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments~k-:""
(Mul~-Family Construction Code) "d,
o
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