HomeMy WebLinkAbout07120103 ApplicationPermit #: 010
City of Carmel/Clay Township
RESIDENTIAL UVOROVEMENT LOCATION PERMIT APPLICATION
,;e`1RNP' For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME.
I PHONE: FAX:
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OF
RECORD: STREET ADDRESS: CITY:
BUILD 'S EMAIL ADD SS: BEST METHOD OF CONTACT:
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PROPERTY
NAME: 'U -A
PHONE: _p FAX:
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OWNER: -
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STREET ADDRESS: / CITY:
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LOCATION LOT #: SUBD1vI ION NAME:
I ? SECTION: ZONING:
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& PROJECT L) C `
INFO:
ION
:
ADDRESS OF CONSTRUCT SQUARE
FOOTAGE: 9/? J
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SEWER UTILITY
PROVIDER: ?r .?
L"i ATER UTILITY
DER: l C. to
rPROVI ESTIMATED COST OF CONSIRUC170N:
(EXCLUDING LAND VALUE) iJi,?
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NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL ANDJOR SEPTIC PERMIT #'S (IF APPLICABLE): -QR CQ
NTRU TIQN
(,( A ?iI;OT-, ? ;• r) I •:
FLOOD ZONE AREA DESIGNATION(S) -( 2 1
Or( I O% O f C*) r„ rao and Lccal Cues.
I] `?Jr= PARCE
i COr
FOR THIS PROPERTY: /°`-t?? ;iMUNITY SF vlr
TYPE OF 6NSTRUCTION:
SINGLE FAMILY
O TOWN HOME
? TWO FAMILY
# of units being
constructed at this
time:
? RESIDENTIAL (For
Additions, Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit: Y_N-
Lot Split: _Y A^
TYPE OF IMPROVEMENT:
ED,,4EW STRUCTURE
? ROOM ADDITION(S)
? PORCH ADDITION(S)
? DECK ADDITION(S)
? REMODEL
_ Basement Finish only
? ACCESSORY BUILDING
? DETACHED GARAGE
ATTACHED GARAGE
? DEMOLITION
Manufactured
Trusses:
Sump Pump:
_Y !/N
O SLAB MSI(SEMENT
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences within 160
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 Adirdrustrative Rules of the State of Indiana (See 675 LAC 12) regarding expiration time frames for beginning and
completing construction.
1, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the Sure of Indiana, and the -Zoning Ordinance of Camel Indiara -1991 (Z-
289) and amendments, adopted under authority of I.C. 56-7 et seq, General Assemblyof the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and Hoot drains are connected to the sanitary sewer. 1 further certify that the construction will not be used or occupied until a Certificate of
Occupanc;"en been issu tment of Community Services, Camel, Indi:nm? ?n ``y?
Prlrn (/?I j1'AWn I'( r /'YIG^Tr(L/ 1 ?wl
ONLY:
MONS REQUIRED: xxx***********x****xx**xxxx**xx*********xx***xx***xxx**x***************xx**x*****
Filing Fees: 13 (Q
Base Inspections: Revi
Under Slab a)`Q7 ed Re-
Reviews
Cert. of Occupancy:
P.R.I.F.: j a?pi . no^^
/ "IrnTAI • -7 't aq m-z
Fee RLfeived by:
PLUMBING CONTifACTORs• / LAY i OWNSHIP
A P ) IN° .-
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PlumbeYs Cana State License #:
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Which plumbing codes will be applied to the construction:
International Residential Code w/Indiana Amendments
O Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
O CRAWL.SPACE 0 POST & _ BEAM -PIER
Additional Fees
Date
S:Pen lts/Farmy'IUI RESIDENTIAL