HomeMy WebLinkAbout07120038 Application`. :07 1 2W3?
.° : City of Carmel/Clay Township Permit #
RESIDENTIAL IMTROVEMENT CATION PERMIT APPLICATION
wn1PNF ;' For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME:
1 PHONE: FAX:
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OF 1
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RECORD: STREET ADORES -
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_ STATE: ZIP:
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ukx ', I BUILDER'S EMAIL ADDRESS:
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I% _" BEST METHOD OF CONTACT: Rapt
PROPERTY
Corn PHONE: FAX:
OWNER' 6v?
Pfd STREET ADDRESS: ?
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COEr STATE: LP:
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LOCATIO OT : _ SUBDIVISION NAME: SECTION: ZONING:
R -1
& PROJECT
INFO: ` ADDRESS OF CONSTRUCTION SQUARE r? I
./6
SEWER UTILITY t
A ? 130 WATER UTILITY ESTIMATED COST OF CONSTRUCTION:
EXCLUDING LAND VALUE
7
PROVIDER: PROVIDER: Ay On
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NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); ANDJOR COUNTY WELL AND/OR SEPTIC PERMIT "S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL Y.
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FOR THIS PROPERTY: D ^
V
TYPE OF CONSTRUCTION:
O SINGLE FAMILY
6 TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
RESIDENTIAL (For
Additions, Remodels, Etc.)
Early Release
Permit:
Lot Split:
_Y _9
_Y _N
TYPE OF IMPROVEMENT:
O NEW STRUCTURE
O ROOM ADDITION(S) S+
O PORCH ADDITION(S) v
O DECK ADDITION(S)
Q
O /?C(p
REMODEL
_ Basement Fi MErtlyT
G
O ACCESSORY BUILDI
od
"
DETACHED GARAGE
LB
O ATTACHED GARAGE
O DEMOLITION
Manufactured
Trusses:
Sump Pump:
/Y /N/
_Y /N
1 Code w/Indiana Amendments
w/Indiana Amendments
,all that apply for the new
POST & - BEAM -PIER
r (VJALKOIUT:Y_N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pemdt is valid jifly-if construction commences within 180
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 16 months of the issuance date. Class 1
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, relccarion, or alteration of a structure, or any change in the use of land or stmctures
requested *.his anplicatien will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel indiana - 1993" (Z-
and : endments, pled under authority of I.C. 36.7 era seq, GeneraLAssembly of the State of Indiana, and all Acts amendatory thereto. 1 further certify that aoly
ki - n. , and floo dr s are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a CeruRcare of
Occ c en ue by the artment of Community Senices, Carmel, Indiana
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nao C Owneor Oriled Agent Print
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ONLY:
O FISE
INSPECTIONS REQUIRED: Filing Fees:
Base Inspections: Charged Re
Upper Footin Lower Footing Under Slab Reviews
Cert. of Occupancy:
site
P. R.I.F.: Additional Fees
? ? TOTAL: 36(9, 50
01p0/?
codes will be applied to the
Review iApp DD t. of Community Serviceg (Date) R 1?-- I I %-P I
S:Petmits/FOrtne/ilP 4ESIDENDAe Fee ReFee Re a Date