HomeMy WebLinkAbout08010014 ApplicationASV ? ?y\
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City of Carmel/Clay Township Permit #:
RESIDENTIAL IMTROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER N'EE'
A 14 PHONE:
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OF
RECORD: STREET ADDRESS: CITY: STATE: ZIP:
BUILDER'S EMAIL ADDRESS:
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e, 6d BEST METHOD OF CONTACT:
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PROPERTY NAME: PHONE: FAX:
OWNER:
STREET ADDRESS: CITY: STATE: ZIP:
LOCATION
& PROJECT LOT SUBDIVISION NAME'
6"1 77?c K SECTION:
f?? ?l ZONING:
S'-
INFO: ADDRESS OF CONSTRUCTION:
(J zt, Z J
l T
".1 4h SQUARE
FOOTAGE: 3 G 3
SEWER UTILITY
PROVIDER: C 1lf C') WATER UTILITY r
PROVIDER: r L '
C a ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) U Q 0 d 0, gJL
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BP'W DOCKET
' I J7
S (IF APPLICABLE):
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT ;#
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL .IA N I
FOR THIS PROPERTY: f
TYPE O CONSTRUCTION:
SINGLE FAMILY
O TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
0 RESIDENTIAL (For
Additions, Remodels, Etc.l
Early Release
Permit _Y _N
Lot Split: _Y --Z?
TYPE IMPROVEMENT:
NEW STRUCTURE
O ROOM ADDITION(S)
O PORCH ADDITION(S)
O DECK ADDITION(S)
O REMODEL
_ Basement Finish only
O ACCESSORY BUILDING
O DETACHED GARAGE
O ATTACHED GARAGE
O DEMOLITION
Manufactured
Trusses: N
Sump Pump: Y _N
LUM G NTRA y 'Ua "4
G1 J " i ? '
TV1 x.
Plumber's Indiana State License
Y 1
1,31 -7 7 7 's
Which plumbing codes will be applied to the construction:
Q14nntemational Residential Code w/Indiana Amendments
C Uniform Plumbing Code w/Indiana
FOUNDATION TYPE: (Check all t?l?pabtfte new
construt io area) w`CJ( ``111 ^'
U CRAWLSPAUcL Q-Q`vR@ BF-?
mences within 180
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures t v :.-"
days of the date of issuance of the building permit, and must be completed (Certificate of Occuu??'Oy1 ssuea? ntl? a isce date. Class 1
nning and
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675'IAC 12) ?gtn \t}{? r begi
completing construction. ??"? ?' ?^,P Q t^
I. the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a 1c ?Q?pr 311y chang? in the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the State of Indian' Zoning Ord:rance of Carmel Indiana -1993' (Z-
289) and amendments, adopted under authority of I.C. 36.7 et seq, General Assembly of the State of India d all Acts amendatory thereto I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupancyhas been issued by the Department of Community Services, eI, Indiana.
S' ature of Owner or Authorized Rent) trt Date
OFFICE USE ONLY: ******************* *?:J? ::???????={={f•f++}
INSPECTIONS REQUIRED: Filing Fees:
pper Footing In Under Sla 21-4e 1, Base Inspections:
' M Cert. of Occupancy:
Rough In Ba inal S' i
P.R.I.F.:
TO
wed/App ved: pt. of Community Services (Date)
T.
S:PaiNts, T,%(ILP RESIDENTIAL
Foa RcroiwA
?? SG, # Charged Re-
Reviews
Additional Fees
3