HomeMy WebLinkAbout07100079 ApplicationPry Permit #:C)7IbO
City of Carmel/Clay Township
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
a For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
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BUILDER NAME. PHONE: FAX:
RECORD: STREET ADDRESS: CITY: STATE: ZIP:
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BUILDER's EMAIL ADDRESS: BEST METHOD OF CONTACT:
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PROPERTY NAME: a Subject to cumuli 3nce vditfl ?u eg lations
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STREET ADDRESS: ^ - 7?n ZIP'
DEPT ?t`GOMA?IUI'JlTY at??/Ii?ES
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LOCATION IV-tr ! v O T0
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LOT #: SUBDIVISION NAME: eipi
/f / _ - I 'ZONING:
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& PROJ
INFO:
ADDRESS OF CONSTRUCTION: SQUARE
FOOTAGE: 6 7719
SEWER UTILITY
PROVIDER: C'J"? LCJO WATER UTILITY
PROVIDER: C?? /
1 ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) 3? Q Jr Q O
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / W / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE): t--
FLOOD ZONE AREA DESIGNATION(S) 071, 00 AX PARCEL u. C
FOR THIS PROPERTY:
P
i QPlO'H1 I,._
TY?PPE//OF CONSTRUCTION:
ItYSINGLE FAMILY
O TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
ED RESIDENTIAL (For
Additions, Remodels, Etc)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
Y _N
_Y _N
TYPE OF IMPROVEMENT:
c NEW STRUCTURE
O ROOM ADDITION(S)
O PORCH ADDITION(S)
O DECK ADDITION(S)
O REMODEL
_ Basement Finish only
O ACCESSORY BUILDING
O DETACHED GARAGE
O ATTACHED GARAGE
O DEMOLITION
Manufactured
Trusses: Y _N
Sump Pump: ?N
PLUMBING CONTRA L-'D l? jf-<<J r(rs
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Plumber's Sndiana State ns `I rrI- J S
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Which plumbing codes will 4tID?:
rl temational Residential Code w/Indiana Amen(
Q Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
O CRAWLSPACE O POST & _ BEAM -PIER
Cg LAB O--?SEMENT(WALKOUf:_Y-i-?
For Single Family and Two Family dwellings, additions, remodels, and/or 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 WC 12) regarding expiration time frames for beginning and
completing construction.
1, the undersigned, agree that any construction, reconstruction, enlargement, refutation, or alteration of a structure, or any change in the use of land or structures
requested by this application will complywith, and confoi-.n to, all applicable laws of the State of Indiana, and the "Zoning Ordirance of Carmel Indiana -1993" (Z-
289) 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 are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Cer e&care of
Qcvu been issued the Deparunent of Community Services, Carmel, Indiana.
SI re of Own. or A 'sd en Print Date
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OFFICE USE ONLY:
Filing Fees:
Under Slab Base Inspections:
Rough In
Base( ,'Final Site
(Date)
S:Pennts1FVnrt/IlA RESIDENTIAL
Cert. of Occupancy:
P.R.I.F.:
TOTAL:
Fee Received bY:
# Charged Re'-
Reviews
%(/ Additional Fees
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