HomeMy WebLinkAbout07080220 Application4?V cr Cgga? I?90
Permit t:
City of Carmel/Clay To 01,
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RESIDENTIAL VEMENT LOCATION PERMIT APPLICATION
aoicx?.% For Single Family, Town Home, Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME: RELE FOR CO?i. I FAX.
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RECORD: STREET ADDRESS: Oi and Lo, Ilmdes. STATE: LP:
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?hQD OF CONTACT:
BUILDERS EMAIL ADDRESS: C, ` (J = ,i / CLAY 'TO r
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PROPERTY NAME: PHONE: FAX:
OWNER: v.R ETT Lt: ?JE-? f-)U\1 1
STREETADDRESS: CITY: STATE: ZIP:
LOCATION LOT 11 : ?S SUBDIVISION NAME: SECTION:
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95 W (? ZONING:
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PROJECT
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INFO: ADDRESS OF CONSTRUCTION: ((?? D (? t?
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SEWER U7 ILITY
PROVIDER:
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ROYIDER: l_.Lll' ?I ESTIMATED OF CONSTRUCTION:
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NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT t'S (IF APPLICABLE): By
FLOOD ZONE AREA DESIGNATI (S) TAX MAP PARCEL:
FOR THIS PROPERTY: .t. i AE
TYPE OF CONSTRU6,36N:
56' SINGLE FAMILY
O TOWN HOME
O TWO FAMILY
# of units being
constructed at this
/ time:
f$/ RESIOENTIAL(For
Additions. Remodels. Etc.l
TY6E OF I4ROVEMENT:
O NEW STRUCTURE
O ROOM ADDITION(S)
O PORCH ADDITION(S)
O DECK ADDITION(S)
ODEL
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Basement Finish only
O ACCESSORY BUILDING
O DETACHED GARAGE
O ATTACHED GARAGE
O DEMOLITION
PLUMBING CONTRACTOR: /v(
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
O International Residential Code w/Indiana Amendments
D Uniform Plumbing Code w/Indiana Amendments
PROJECT INFORMATION:
Early Release
Permit: Y N
Lot Split: Y ?N
Manufactured
Trusses: _Y _N
Sump Pump: _ZY _N
FOUNDATION TYPE: (Check all that apply for the new
construction area)
O CRAWLSPACE O POST & BEAM -/PIER
O SLAB BASEMENT (WALKOUT:_Y! N )
For Single Family and Two Family dwellings, additions, remodels, andlor accessory structures, this permit is valid only if construction commences within 180
days of the dare of issuance of the building permit, and must be completed (Certificate of occupancy issued) within 16 months of the issuance date. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 65 IAC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any co:ssttuction, _econstruction, enlargemer-t, relocation, or alteration o: a structure, or any change in the use of land or structures
requested by dais application wvtll comply with, and for forte, to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Camtcl Indiana -199Y (2-
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 sewer. 1 further certify that the construction will not be used or occupied until a Certificate of
Occup?ncyhas been issued by the Department of Community Services, Carmel, Indiana-
S,.ratom of Owner ' ea Ay Print Date
OFFICE USE :zzzz*zzsz****z*zz***zz**zzz*z*zzz***z**z*****zzzzz**?z**zzzzz zzzzzzzz******z**
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INSPECTIONS REQUIRED: Filing Fees:
Base Inspections: # Charged Re-
Upper Footing Lower Footing Under Slab _ Reviews
- Cert. of Occupancy: ?? S U
ough In Meter Base inal Si
P.R.I.F.: Additional Fees
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Reviewed/A T ed: pt. f tbmrrtfillity Services (Date) .:
SPe.les(Fonr, ,/ILP RE5tDEtfT1A Fee Receiv?d by: Date