HomeMy WebLinkAbout07080155 Application'd ° City of Carmel/Clay Township Permit #: 0
L RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
`01PM, ' For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME: PHONE: FAX:
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OF
RECORD: STREET AD ESS: CITY:
?? STATE:
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ZIP:
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BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
PROPERTY NAME' PHONE: FAX:
OWNER
:
STREET ADDRESS: CITY: STATE: ZIP'
LOCATION LOT.: SUBDIVISION NAME: SECTION:
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/ ZONIN '
& PROJECT ,
INFO: ADDRESS OF CONSTRUCTION: /t
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G SQUARE
FOOTAGE:
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SEWER UTILITY
PROVIDER: ?
?"- &-?0A WATER UTI
Lfry-
PROVIDER:
OF CONSTRUCTION: ?I f
ESTIMATED CC)
(EXCLUDING LAND VALUE) Gi3 Y _ C U
`
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPN DOCKET
NUMBERS; TAC DAT ABLE): I
E(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #S (IF APPLIC
FLOOD ZONE AREA C
DESIGNATION(S) 40'08 p I:J TAX JVM&L[b
FOR THIS PROPERTY: A
TYPE OF CONSTRUCTION:
9--SINGLE FAMILY
? TOWN HOME
O TWO FAMILY
At of units being
constructed at this
time:
? RESIDENTIAL (For
Additions. Remodels. Etc.)
PRO)ECTINFORMATION:
Early Release
Permit: -Y -N
Lot Split: _Y _N
TYPE OF IMPROVEMENT:
STRUCTURE
? ROOM ADDITION(S)
? PORCH ADDITION(S)
? DECK ADDITION(S)
REMODEL
_ Basement Finish only
O ACCESSORY BUILDING
? DETACHED GARAGE
? ATTACHED GARAGE
? DEMOLITION
Manufactured ,.
Trusses: c- y N
Sump Pump: _Y _N
PLUMBING C00ft Ctt)?If I CUU/ (fillik 'V .O? I'llk
Plumbers India a4 _ _
/J t-ri0 y ?dj
Which plumbing codes will be applied to the construction:
L'-Intemational Residential Code w/Indiana Amendments
O Uniform Plumbing Code w/Indiana t\+l?d9ments
FOUNDATION TYPE: (Check a?N for the new
construction area) ._a?j %to i5
Y
i t V o on uon commences within 180
For Single Family andTwo Familydwellings, additions, remodels, andbr accessorystruccur l
days of the date of issuance of the building permit, and must be completed (Certificate of Iss ot?t a issuance date. Class I
structure permits are subject to the General Admirustrative Rules of the State of Indiana (See 4C 12) ro frames for beginning and
completing construction. v ((?Q? ??
1, the undersigned, agree that any construction, _econstruction, enlargemert, relocaticn, o- alteration ofloctojowy change in the use of land o: structures
requested by this application will comply with, and confartr. to, all applicable laws of the State of Indiana, h Zoning Ordinance of Cannel Indiana -1993" (7-
239) and amendments, adopted under auchoriry of I.C. 36-7 et seq. General Assembly of the State of Indi.h%, d all Acts amendatory thereto. 1 further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not he used or occupied until a CertiScate of
Occupancyhas been i ued the Department of Community Sereices, Carmel, Indiana.
gnanne of owner or pudwri Agee Print Date
*xxxxx*xxxxxx***x*xx***x*x****xx*x*xxx*****xx*xx**xx x**? **xx***x**,x*xxxx
OFFICE USE ONLY:
INSPE SREQUIRED: Filing Fees: a Charged Re
caper Footin Lower Footing Under Slab Base Inspections: Reviews
cert. of Occupancy: b?
Rough In Meter Base Final Site J j
P. R.I.F.: Additional Fees
C?a.?? 1?-11,s??z. 8-22-47
Reviewed/Approved: Dep of Community Services (Date)
3? 0
S:P its,Fcors]ILP RESIDENTIAL Fee Received by: Date