HomeMy WebLinkAbout07100199 Application)r7 Do19
City of Cartel/Clay Township Permit #:
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
?f4or,±nP? For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER l ??U +? PHONE: ^ \?_^? FAX:
OF
RECORD: STREET ADDRES . ??> CITY: STATE:
C?um2 D2 GA-OnL
?ti ZIP:
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BUILDER'S EMAIL ADDRESS' 7 '?}?)?J , A4
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PROPERTY NAME: PHONE:
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OWNER: C
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5TREADDRESS:?t `Wr ' • '..-v'\ Y/[iI t`l? V "`'l / f ? ? 1V
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LOCATION LOT #: SUBQ ?NAl+y: C' SECTION:
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INFO: ADDRP/ 5 S F CONSMUCTION:
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FOOTAGE: Z to
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SEWER ImLFFY
PROVIDER: WATER UTILITY
PROVIDER: ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) LAS
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S) / `-
k TAX MAP PARCEL #:
FOR THIS PROPERTY: 7
TYPE OF CONSTRUCTION:
? SINGLE FAMILY
G TOWN HOME
? TWO FAMILY
# of units being
constructed at this
time:
RESIDENTIAL (For
Additions, Remodels. Etc)
TYPE OF IMPROVEMENT:
NEW STRUCTURE
0 ROOM ADDITION(S)
? PORCH ADDITION(S)
? ECK ADDIT,?i
REMODEL VV??ss
_ Basemen
O ACCESSOWTBUIL rill
PROTECT INFORMATION: /
U
O
Early Release anufactured
Permit: _Y N Trusses: Y
Lot Split: -Y _N Sump Pump: _Y
PLUMBING CONTRACTOR:
State
N' pluin6ing codes will be appried to the construction:
International Residential Code w/Indiana Amendments
Sf ' oy [form Plumbing Code w/Indiana Amendments
dtO0 dqc, Al"
C? ?? o k PE: (Check all that apply for the new
eons, o {
'?/F // (???ry 0/ `4 ? POST & _ BEAM PI
N /A,.'C"TY S`LY11(AB n BASEMENT (WALKOIJr:Y_N)
For Single Family and Two Family dwellings, additions, remodels, andlor accessory structures, this f"fs valid only if construction commences within 180
days of the date of issuance of the building permit, and must be completed (Certificate of Oceupara ) 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 1.AC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any construction, reconstmcdon, enlargement, relocation, or alteration of a structure, or any change in the use of laid or strucmtrs
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the -Zoning Ordnance of Carmel Indiana-1993' (7-
269) and amendments,adopred under authonry of LC. 36-7et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. 1 further certify that only
ldrehen, bath, and floorArauss are connec55ggc to the sanitary• sewer. I further certify that the construction will not be used or occupied until a Certificate of
Oceu c • en d h t De fiAmetti of Communft Services, C el, Indiana.
( I y A cal &s 111/5
SignatureyDwner m Autlwrizea Agent a Print Date
*s************************x**************************:***.**jr?r***s**ss*********
OFFICE USE ONLY:
INSPECTIONS REQUIRED: Filing Fees: `
Base Inspections: /? ?n # Charged Re-
Upper Footing Lower Footing Under Slab Reviews
Cert. of Occupancy: 5-5- .?
Rough In Meter Base final Site
0 W
P.R.LF.: Additional Fees
?ngcn 77
Reviewed/Approved: Dept. of Community Services (Date) - ??
P
S:Pennn/Foans1lLP R=SDcNnAL
Fee Recelvel W: Date