HomeMy WebLinkAbout07120088 Application- 1
City of Carmel/Clay Township
Permit #: rl 'I'IA00 P
RESIDENTIAL IMTROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF NAME.
? L ? Y? 40 M 6- -M 646--n09 F i - 7 __? 3 --?369
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RECORD' STREETADD 5: an: STATE: ZIP:
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EST METHOD OF CONTACT:'
BUILDER'S EMAIL ADDRESS:
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PROPERTY
FAX:
PHONE: ?? Z
NAME:
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OWNER: ,
STREET ADDRESS: CITY: STATE: P:
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LOCATION LOT #: r SUB VISION NAME: SECTION: ZONING-
& PROJECT Ar f -
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2 CI
INFO: 55?R/U1
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9 FOSQUARE
OTAGE: 3 ?r
SEWER UTILITY
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PROVIDER: UiI
LITY e?
WATER
PROVIDER: ESTIMATSTIMATED COST V T
U
(NGLANDV
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / 8ZA / BPW DOCKET 1 1 n u
OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE): ?(
S
ND f
NUMBERS; TAC DATE(
); A
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DU 9,
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FLOOD ZONE AREA DE5IGNATION(S) ` r ??
FOR THIS PROPERTY: /V TAX MAP PAR LL #:
,y
TYPE OF CONSTRUCTION:
? SINGLE FAMILY
0 TOWN HOME
? TWO FAMILY
# of units being
constructed at this
time:
qf'IRESIDENTIAL(For
Additions, Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_Y !/N
_Y 7N
TYPE OF IMPROVEMENT:
O NEW STRUCTURE
? ROOM ADDITION(S)
? PORCH ADDITION(S)
? DECK ADDITION(S)
? REMODEL
_ Basement Finish only
? ACCESSORY BUILDING
V-bETACHED GARAGE
O ATTACHED GARAGE
O DEMOLITION
Manufactured
Trusses:
Sump Pump:
Z Y -N
_Y -4e!9'
Plumber's Indiana State
Which plumbing codes wi#,6e apd(ed to the
.;d'ffntemational Residential Code w/Indiana Amendments
L Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
O CcRAWLSPACE O POST & _ BEAM -PIER
b'SLAB ? BASEMENT (WAL.KOUT Y_N)
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 IAC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any cor structioa, reconstruction, enlargement, relocation, or alteration of a structure, or arty change in the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Came( Indiana -1993" (2-
289) and amendmenrs, adopted under authority.C. 36-7 et seq, Gmecal Assembly of the State of Indiana, and all Acts amendatory' thereto. I further certify that only
kitchen, bats, an r drains are connected t sanitary sewer. I further certifv that the construction will not be used or occupied until a Certificate of
Occupancy t e t e of Community sendces, Carmel Indiana.
1171b 7
51e?GV -? i z
Sig reor Owner or Authorized Agent PHnt Date
OFFICE USE ONLY: *************************s***************x************d***O********************
I ECTIONS REQUIRED: Fling Fees: ?4fY ?^
Base Inspections: JV Charged Re-
Upper Footi Lower Footing Under Slab Reviews
Cert. of Occupancy:
Rough In Meter Base'
a_A
Reviewed ved: Dept. a munity Services (Date)
s:Per. ,y1LP RESIDENTIAL
P.R.I.F.: Additional Fees