HomeMy WebLinkAbout07100065 ApplicationoAR t Ip o o o 5
City of Carmel/Clay Township Permit #:
', RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
a a? For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF NAME. n
NU - rf?olltv_'T163 PHONE:
-517-36(P-39? FAX:
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7-?
? 37
RECORD: STREETADDRESS:
D -CITY: STATE:
/
/ ZIP:
6256
5 ES' or r
ie n
r1/Uir3i11h000td
1 le BUILDERS EMAIL ADDRESS:
1
iI BEST METHOD OF CONTACT:
w
?i4OA/r
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-
S rrnann 02f-Co
PROPERTY NAME:
?E
S
57 A AB PN NE: FAX:
OWNER o
Pr41 1
:
STREET ADDRESS: STATE: ZIP:
LOCATION LOT SUBDIVISION NAME: SECTION: ZONING:
PROJECT
&
f j 1 ,
SQUARE
INFO: ADDRESS OF CONSTRUCTION:
0 T N , _ J G" 1 FOOTAGE:
SEWER UTILITY WATER UTILITY MATED COST OF CONSTRUCTI ON:
PROVIDER: PROVIDER: $y (IXCWDING LAND VALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCICEF
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #5 (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY: TAX MAP PARCEL #:
- S -
-Q -QZG
/o I
.
TYPE OF CONSTRUCTION:
? SINGLE FAMILY
? TOWN HOME
? TWO FAMILY
# of units being
constructed at this
time:
? RESIDENTIAL(For
Additions. Remodels,
TYPE OF IMPROVEMENT:
O NEW STRUCTURE
? ROOM ADDITION(S)
?- PORCH ADDITION(S)
? DECKADDITION(S)
? REMODEL
TiBasement Finish only
PP 'ACCESSORY BUILDING
0-,.DETACHED GARAGE
O t-U` _ i;?i`.'CJ ATTACI
ft N? FqOC n4? _ r-'DEMOL
EadyR?ease o S'TION,1`l1TJ?11M ?ufac?WBre
Permit: Y0`? OTrusseI
Lot Split:QEP _,! yRN," 4iSUmp Pump:
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
O International Residential Code w/Indiana Amendments
O Uniform Plumbing Code w/Indiana Amendments
tr FOUNDATION TYPE: (Check all that apply for the new
1P construction area)
_Y _N O CRAWLSPACE 0 POST & _ BEAM I PIER
_Y _N Q SLAB ? BASEMENT (WALKOUT:_Y l N )
For Sing l Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences within 180
days of the daze of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance daze. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 LAC 12) regarding expiration time frames for beginning and
completing construction.
1, the undersigned, agree that any consrruction, reconstruction. enlargement. relocation, m alterationof a arrcctute, or any change in the use of land or structures
requested by this anpliCation will comply with, and conform to, all applicable laws of tie Stare of Indiana, and the -Zoning Ordinance of Carmel Indiana -1993" (2-
289) and amendments, adopted under authority of LC. 367 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto- 1 further certify that only
kitchen, ba nd floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occv as be c y the Department of Community Services. Carmel, Indiana.
s„ ui S7tyEA/ Jt ,?R6C2MAJ,J A-?I LOO)
Sio re of own or Aulhorvat Agent Print (MIA _
i
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OFFICE USE ONLY:
INSPECTIONS REQUIRED: Filing Fees: rl
Base Inspections: 5 /i So Reviews # edRe-
Upper Footing Lower Footing Under
Rough In Meter Base
Final Si
Im • c I r I Z A7
Reviewed/A proved: Dept. of Community Services (Date)
S:Pe ,WWrms/10 RESIDENTIAL
Cert, of Occupancy:
P.R.I.F.:
Mob
Additional Fees
,. I add.