HomeMy WebLinkAbout07120054 Applicationii ov trq\
"`'• City of Carfnei/Clay Township Permit # d
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' OV' RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
raolpr'-? For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME. PHONE: FAX:
OF e.TRIP? b -Q,5)O Bz-0Ay5
RECORD: STREET ADDRESS: CITY:
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STATE: ZIP:
50
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BUILDER'S EMAIL AD RESS: BEST METHOD OF CONTACT:
h,i+peRS? eSfRfOtt e .ae.T- 664- 85io
PROPERTY NAME. PHONE: FAX:
OWNER: e5TRIOL .-
STREETADDRESS: CITY: STATE: ZIP:
LOCATION LOT #: SUBDIVISION NAME: SECTION: ZONING:
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bNShlap
13 i I 5-
&PROJECT ,
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INFO: ADDRESS OF CONSTRUCTION: SQUARE /
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Iy 7.Z v P A CI aC{e CAST FOOTAGE: hb p
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SEWER UTILITY WATER UTILRY0
j/ J01O 0 S3 ESTIMATED COST OF CONSTRUCTION:
PROVIDER:
GI 4
PROVIDER: 1[V'_'e
C?1/I}
(EXCLUDING LAND VALUE)
G`O
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NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT n'S (IF APPUCABLE): LJ (? R C..UI.)STR V G 116 C
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL;:: fOr A@
Off'
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
SINGLE. FAMILY
TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
O RESIDENTIAL(For
Additions, Remodels, Etc)
PROJECT INFORMATION:
Early Release
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Permit: N
Y -j
Lot Split: Y -*N
TYPE OF IMPROVEMENT:
A- NEW STRUCTURE
O ROOM ADDITION(S)
O PORCH ADDITION(S)
O DECK ADDITION(S)
O REMODEL
_ Basement Finish only
O ACCESSORY BUILDING
D DETACHED GARAGE
D ATTACHED GARAGE
O DEMOLITION
PLUMBING CONTRACTOR:
State License
SfDby51
Which plumbing codes will be applied
X International Residential Coe
O Uniform Plumbing Code w/Ir
w/Indiana Amendments
(Check all that apply for the new
Manufactured construction area)
Trusses: _Y N O CRAWLSPACE O POST & _ BEAM -PIER
Sump Pump: -)(Y _N a SLAB `K BASEMENT (WALKOIIT:_Y?)
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 l
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.
I, the undersigned, agree that any construction, reconstractior, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this application vt]I comply with, and conforn to, al applicable laws of the State of Indiana, and the 'Zoning Ordinance of Carmel Indiana -1993' (7 -
2B9) and amendments, adopted under au:honry of I.C. 36-7 et seq,Geneml Assembly of the State of Indiana, and all Acts amendatory thereto. I Further cerrlly Chat oniy
Idtehen, bath, and o drains are rnrnecced to Lhe sanita i sewer. I further certify that the construction will not be used or occupied until a Certificateof
Occupanc lu b t ued by the Department of Community Services, Carmel, In ans.
6ej ffiAl??ckl e i/
Signaturk Owner m Authorizes Agent Print Date
*xxxxxx*******xxxxx*x*xxxxxxx***xxx*******xxx****xx*xx+:**:xf** *xxxx*****xx***:.
OFFICE USE ONLY:
SPECTIONS RE UIRED: Filing Fees: 76
Base Inspections: cX ?? _?-d # Charged Re-
Upper Footin Lower Footin Under Slab Reviews
- Cert. of Occupancy: S
R In eterea Final Site I,J
P.R.LF.; _ /vim Additional Fees
4? g ?iS i2-'6-0'7
ewewedjAp Dept. of Community Services (Dat )
AL:
S:PenniWFO ILP RESIDENTIAL Fee