HomeMy WebLinkAbout07100053 Application``• ?',, City of Carmel/Clay Township Permit #: C) r D0 065
RESIDENTIAL UVIPROVEMENT LOCATION PERMIT APPLICATION
,, e1Pyp j For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF NAME'
J 1 ANNE., PHONE: FAX:
3f7 16-13 )a
RECORD: STREET ADDRESS: CITY: STATE: ZIP:
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BUILDER'S EMAIL ADDRESS: BEST METHOD O
TNk Neefll-.<GAnf?ti
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PROPERTY
OWNER: NAME
JC (/- ,IoRrJ Ek PHONE: FAX:
3 r 7 44. 3 OCT -
FTREETADDRES& CITY: B STATE: ZI
l7 ?0'YC/- C I- C RM
LOCATION LOT #: SUBDIVISION NAME: SECTION: ZO
& PROJECT r< sA el? 1?J5 ifs Sa o /
INFO: ADDRESS OF CONSTRUCTION: SQUARE
FOOTAGE: C1 U
K?z
SEWER UTILITY
f) `''--"?
WATER IJ#:
I
''° ESTIMATED COST OF CONSTRUCTION: r
(EXCLUDING LAND VALUE) ZP3
PROVIDER:
'M 0 =%_& G
?
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN CO ISSION /: _ 6
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/O, t# ., _LI- .
'G.•. ii
FLOOD ZONE AREA DESIGNATION(S) Y? I ?.,(7r' r`Cl,t tt7? $l/I?
••.::
?`
i PARCEL #:
FOR THIS PROPERTY: ..
;; ,:: '19-
h, ..
!v a-
6 , 000
Z 0 0 Q 700
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T
TYPE OF CONSTRUCTION:
O SINGLE FAMILY
O TOWN HOME
O TWO FAMILY
# of units being
constructed at this
0 RESIDENTIAL (For
\ Additions, Remodels, Etc.)
i
IQI
PROJECT INFORMATION:
Early Release
Permit: -Y _N
R:
TYPE OFIMPROVEb'?Bfq1'?(r7 CONTRACTO
O NEW STRUCTURE )q '- 0
l'VA7..
O ROOM ADDITION(S)
O PORCH ADDITION(S) plumber na State License #:
O DECK ADDITION(S)
O REMODEL which plumbing codes will be applied to the construction:
_ Basement Finish only
ACCESSORY BUILDING o International Residential Code w/Indiana Amendments
O ATTACHED GARAGE 1rp O Uniform Plumbing Code w/Indiana Amendments
O DEMOLITION FOUNDATION TYPE: (Check all that apply for the new
Manufactured
Trusses:
Lot Split: _Y _N Sump Pump:
construction area)
_Y AN O CRAWLSPACE ® POST&ZBEAMPIER
_Y _N 0 SLAB O BASEMENT(WALKOUT:Y_N)
For Single Family and Two Family dwellings, additions, remodels, andior accessory structures, this permit 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
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 IAC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any constructon, 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 conform to, all applicable laws of the State of Indiana, and the 'Zoning O:dir ance of Carmel Indiana - 1993' (Z-
299) and amendments, adopted under authority of I.C. 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 ate corrected to the sanitari sewer. I further certify that the construction will nor be used or occupied until a Certificate of
Occupancy-has been issued by the Department of Community Services, Carmel, Indiana.
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O& JF NR <A , k e-
Signatu or AuthorizM Agent Print Date
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`OFFICE USE ONLY:
INSPECTIONS REQUIRED: Filing Fees: L G
d Re-
aS
Base Inspections: #
Upper Footin Lower Footing Under Slab
Cert. of Occupancy: Reviews
Rough In Meter Base Final Site
P.R.I.F.: Additional Feeso
TOT 0 d o?I} ?S<
Reviewed/Approved: Dept. of Community Services (Date) ems'
S;P orrslFa SCLP RESIPErm Fee Received W: Date