HomeMy WebLinkAbout07100194 ApplicationPermit #:
i. City of Carmel /Clay Township
RESIDENTIAL UVIPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF NAMED L PHONE: 7S "c FAX:
RECORD: STREET ADDRESS:
192 nl ME1101Ik1\j CITY: STATE: ZIP:
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BUILDER' DRESS: /? . BEST METHOD
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PROPERTY NAME. -
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OWNER:
STREET ADDRESS: CITY: STATE: ZIP:
LOCATION
OT SUBDIVISION NAME: SEC ON:
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ZONING:
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PROVIDER:
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WATER UTILITY
PROVIDER:
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ESTIMATED COST OF CONSTRUCTION: 93
(IXCLUDING LAND VALUE)
(EXCLUDING
ID
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN CO ERf.1
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OR COUNTY WELL AND/O
TAC DATE
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FLOOD ZONE AREA DESIGNATION(S) I1 i I
FOR THIS PROPERTY:
I TAX MAP PARCEL #:
1??o?22?W= L -(J ?. I_oO(f
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TYPE OF CONSTRUCTION: TYPE O IMPROVEMENT: LUMBING CONTRACTOR: ,
Gal SINGLE FAMILY N B wYI hq + %S(D V S
O TOWN HOME O RO ON(S) Plumbers Indiana State License #:
O TWO FAMILY O PO
# of units being ED DE 4VGj?IF prk' ?OR CQt"y-S-? + 1.?T? lJl le J I V
constructed at this 0 REMODEL mP1ianCe Vy. ' - t7 ill s will be applied to the construction:
time:
(w'l?thtl LOCf QQ 11?I^
O RESIDENTIAL (For ? '?88ItD?IhG 8 i ?YnD2it0'n®6Residential Code w/Indiana Amendments
Additions, Remodels. Etc.) O MIAV! ""UN17-6 j mbing Code w/Indiana Amendments
? ATiA - diA • DEL % CLAY"T?S
PROJECT INFORMATION: O DEMOLITION ?NC?p TYPE: (Check all that apply for the new
Early Release ? Manufactured i/ V? constructs
Permit: _Y N Trusses: Y N O CRAWLSPACE O POST & _ BEAM -PIER
Lot Split: _Y 'vN Sump Pump: Q/V N D SLAB &-CEBASEMENT (WALKCU-r: Y N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences within ISO
days of the dare of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within IB months of the issuance daze. Class I
structure permits are subject to the General Adniinjstrative 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 construction, reconstruction, enlargement. relocation, or ahnrtiot of a structure, many change in the use of land or structures
requested by tits application, will comply with, and conform to, all applicable laws of the State of Indiana, and the -Zoning Ordinance of Camel Indiana - 993' (7-
239) and amendments, adopted under authority of I.C. 36.7 et seq, General Assembly of the State of Indiana, and all Acts amendaror, thereto. I father certify that only
kitchen, bath, and floor drains are connected to :he sanitarysewer. I further certify that the construction will not be used m occupied until a Cera6cate of
Occupancyhas been issue by the Department of Community Servcs, Carmel, Indiana
mah0 JA P? OMNE SNEPN?P? po 4o
SE ONLY: C ?
PECTIONS RE UIRED: Fling Fees:
j O
?? Base Inspections: 2 # Charged Re-
Upper Foot g (Lower Footing Under Slab Reviews
Cert. of Occupancy: L5 J>?
Rough Irv eter Base Final Site
Reviewed/Approved: Dept. of Community Services (Date)
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