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Township (� ' iki-5- Permit No. v` •
Hold#: • U mprovement Location Permit Date
Roll File
This permit is valid only if construction is started within 180 days of the date of issuance for residential construction;and for commercial projects,within one(1)
year of the date of issuance of the State Commercial Design Release. All construction must be completed(c/o issued)within 2 years of the issuance date.
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BUILDER QcCtp 1 311' 'Ci�G �� "mod'alf
STREET CITY STATE ZIP
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TENANT NAME Subject to compliance with ail Regulations
(If applicable) of State and Local Code's ,
uEPT-OF COMbirtitinY SCRV1*'f$
AMEOWNER N��tr`C�� C--��d� C.-rap
--� PHONECITY OF CG��AEL��t..AY '1'ihWNSHIP
STREET CITY yt11 l A►N��A 0 R 200- '.\
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LOT SUBDIVISION i SECTIO —
LOCATION 131 V \`Ul 6' U�� lt4 t
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ADDRESS OF CONSTRUCTION
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A. TYPE OF CONSTRUCTION Do plan include a porch? F. TYPE OF IMPROVEMENT
1. t� Single Family &Yes 0 No 1. NY'New Structure
2. ❑ Two Family 2. 0 Addition: Porch Room
3. 0 Multi-Family Type of Foundation 3. 0 Remodel ❑ Commercial Tenant Space
4. 0 Commercial/Industrial 0 Crawlspace 4. 0 Foundation Only
5. 0 OTHER lir Basement 5. 0 Demolition
(Specify) 0 Slab 6. 0 Accessory Building
B. SEWER: / � 7. 0 Garage Detached Attached
l 1. ' Public (Name of system `\ t..% )
2. 0 Private(County permit# ) G. Lot Split YES NO 0/
C. WA'TEA: H. Flood Zones YES NO
1. le' Public (Name of system -Y�) ) I. Sump Pump YES NO
2. 0 Private(County permit# ) J. Manufactured Trusses YES NO
D. ZONING : .--‘?V\ K. Plumbing Contractor Lb. V M 1`e `(\\c0`
E. ESTIMATED COST OF CONSTRUCTION IRC Plumbing Code: ❑ lumber's
(Excluding Land Value) '361‘qLG Indiana Plumbing Code: a License#: 1 Coil.Qli'3
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I,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 State of Indiana,and the"Zoning Ordinance of Carmel Indiana-1993"
(Z-289)and amendments,adopted under authority of I.C.36-7 et seq,General Assembly of the State of Indiana,and 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
rcate of Oc ancy has be issued by the Department of Community Services,Carmel,Indiana.
INSPECTIONS NEEDED:
Si t re of Owner or Authorized A ent e /1 Footin l) nder Slab 'ough- . 1(ter Base
i � C/O
1\Z_QP\TY\Ck_k( '�CO Sq.Ft. iota
(Print) (Phone Number) q
Filing Fees: (I f
E-Mail: Mlle` Q1 1����\ .�1m Inspection Fees ` 'U
36ant Cert. of Occupancy: a
.\/Pla C ssionBB ZAP ' locket#'s;TAC Date(s) P.R.LF.: 5"-ia4
T TAL: i /
Reviewe roved: Dept.of Community Services Received by S:Permits/Forms/ILP2-02