HomeMy WebLinkAbout08020023 ApplicationCity of CarmdlClay Township Permit #.
RESIDENTIAL EMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME: PWN
k /T 5? V 0 FAX:
OF
RECORD: CITY:
STREET ADO S: 6
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- STATE: ZIP:
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BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONT
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P OPER NAME: PHo
J :L t- ll FAX:
OWNER: 44
4
STREET ADDRESS: CITY: C - '? - STA-Ft-
r r ZIP:
LOCATION LOT #: ?A SUBDIVISION NAME: ZONING:
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& PROJECT t6t fC? I /
INFO: ADDRESS OF CONSTRUCTION: / f f
/ SQUARE ?f L a
FOOTAGE
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SEWER UTILITY
PROVIDER: C WATER UTILITY
PROVIDER: ESTIMATED COST OF CONSTRUCTION: -7
7 GI 3
(EXCLUDING LAND VALUE)
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NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION ; BZA f BPW DOCKET
NUMBERS; TAC DATE(S); AND
IOR COUNTY WELL ANDICR SEPTIC PERMIT #'S (IF APPLICABLE): i
,
FLOOD ZONE AREA DESIGNATION(S) J TAX MAP PARCEL
FOR THIS PROPERTY:
TYPE O CONSTRU I N:
SINGLE FAMILY
? TOWN HOME
? TWO FAMILY
# of units being
constructed at this
time:
0 RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFOR MATION:
Early Release
P
i
Y
erm
t: _
M
Lot Split: Y _N
TYPE OF IMPROVEMENT:
IEW STRUCTURE
0 ROOM ADDITION(S)
O PORCH ADDITION(S)
O DECKADDITION(S)
C7 REMODEL
_ Basement Finish only
O ACCESSORY BUILDING
O DETACHED GARAGE
O ATTACHED GARAGE
O DEMOLITION
Manufactured
Trusses: N
Sump Pump: _Y _N
L MB CONTRACTOR:
Plumb s Indiana State License
Which plumbing codes will be applied to the construction:
Gc -Mtemational Residential Code wfIndiana Amendments
? Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
Construction area) _-i
? CRAWLSPACE
Q_SLAB r, a
BEAM -PIER
For Single Family and Two Family: dwellings, additions, remodels, andlor accessory structures, oa§ permit is valid only 4f cgasr t3iiiersces within 180
days of the date of issuance of the building permit, and must be completed (Certifica ? Dceupaucy *iieQ xkthlrj I61n(t?t uance date. Class I
structure permits are subject to the General Administrative Rules of the State of I See i tAG 13} ardin lxp?ttatifbzUWi Karnes for beginning and
completing tons
I, the undersigned, agree that any construetian, reconstruction, enlargement, rel«ation, alteranor. ta(sfj?Ciire ap lt'ha a in the use of land or structures
requested by this applicarion will comply with, and conform to, al: applicable laws of the State o iAnA; an4 * `t!-a , di nce o(Carmel Indiana -1993" (Z-
289) and amendments, adopted under authority of LC 36-7 et seq, General Assembly of tI•,e ?f 4,61 all i id iendatory thereto I further certify that only
kitchen, bath, and floor drains are connected to t:ne sanitary sewer I further certify: that the on will not used or occupied until a CemCkcare of
Occupancy has been issued by the artment of Community: Services, Carmel, Indian
Sane of Chvrnw or Authorized en Prior Date
OFFICE USE ONLY._*************************************w*****?x*********?*r**************************
INSPECTIONS REQUIRED; Filing Fees:
# Charged Re-
Upper Feting footing Under Wb Base Inspections:,, Reviews
Cert. of Occupancy: ,
Rough In star Ba final Site
P.R.I.F.: oe r a 40 10 Additional Fees
TOTAL: , Z
Reviewedf roved: Dept. of Community Services (Date) tiE r
1
S:Perm1tVForm5/t RESMENTIAt
Fee ivewJ by; Date