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CITY STATE
FAX
PLAN COMMISSION
; AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
TYP ,F -N TRU- ,N: TYPE :FIMPR VEMENT: PLUMBING CONTRACTOR:
~ SINGLE FAMILY
TOWN HOME CD NEW STRUCTURE
[] TWO FAMILY [] ~,OOM ADDITION(S) Plumber's Indiana State License #: I
# of units PORCH ADDIcTION(S)
[] MULT!~FAM~L--~ .~ REMODELA~,~Fr~
# of Units: [] ACCESSORY BUILDING
,.~ RESIDENTIA~-~or /]] DETACHED GARAGE
Additions, Remodels, Etc.) .Q~ A1TACHED GARAGE
[] DEMOLITION
/Manufactured
y /
Permit: ' N Trusses, Y /N
Lot Split: Y.~Y~Sump Pump: ----y --~ E] CRAWLSPACE
:] S AB POST & BEAM
BASEMENT
Does any part of the property lie within a special Flood designation area' Y ~ WALKOUT: y~
For Single Family and Two Family dwellings additions remodels and~uermi~ is w~ ' '~
'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 permtts are subject to the Genera] Ad~mmsta:ative Rules of the State of Indiana tSee 675 IAC 12) regarding expiration
th'ne frames for beginning and completing construcuon
I, thc undersigned, agree cb. at au~y consrrucnon, reconstruction etdargrment, relocation, or alteration of a structure, or any change in the use of land or
structures requested by this application ,a411 comply with and conform to. all applicable laws of the State of Indiana and the ~ZonLng Ordinance of Carmel
Indiana - tmendmenrs, adopted under au of t C 36-7 et seq, General Assembly of the State of Indiana and all Acts amendatory
thereto, l i and floor sewer. 1 turther certify that the construction will not be
Signature ~
OFFI~CE USE ONLY: ***'
Lower Foot ng
~ Meter Base
Which plumbing COdes will be applied to the COnstruction:
[D International Residential Code w/lndiana Amendments
[D Uniform Plumbing Code w/Indiana Amendments
(Multi-FamiJy Constructi, on Code)
: (Check all that apply for the new
Services
/ Services, Carmel. Indiana.
Print ~
Filin~Fees: ~~_~. ~***************
)ns: ~ ,~ # Charged Re-