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City of Carmell Clay Township J\.-s) Permit #()bD I D I 00
RESIDENTIAL IMPROVEMENT LOCATIOJVM{RMIT APPLICATION
For Single Family, Multi-Family, llt Two Family: New Structures, Additions, Remodels, llt Accessory Structures
BUILDER of
RECORD:
NAME ((PM
STREIT ADDRESS
I 1'2'2-
PHONE
8' (".-909 (
'L CITY C}I-1l-hdR
FAX
S7/-'1/S3
ZIP
~:::r3
BEST METHOD OF CONTAcr: ." 0 -,." G.~ o;t
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STATE
IN
BUILDER'S EMAlL ADDRESS
t? J<; t<OElfLIN
aOL .c:...rI:lm
PROPERTY
OWNER:
NAME
.5~
CITY
q S-G. EII~T{/\Jtc/C C/(l.. ~
IV woO:h-
PHONE
FAX
SQUARE ,
FOOTAGE: t)
SEWER UTILITY /' A-LJ _ ~ o:Jt c::1 _ . ~. tJ EST1MATED COST OF CONSTRUCTION:
PROVIDER: l..4TX'~ ~ (EXCLUDINGLANOVALUE) .:z,-{: ,;;);) 0
NAME OF UTILITY EXCAVATION CONTRAcrOR; PLAN COMMISSION / BZA/ BPW DOCl<ET~ 1=0 IAN"J't'T1 0",-...... rl-'t:'1:';]7HfI'J: ~
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE): VoJ T'cll.. _! 'l),IIC:: 'rErc'Aiv~/~ r
lYPE OF CONSTRUCTION: lYPE OF IMPROVEMENT: PLUMBING CONT~~OR: "HI 'i - S'i Gbl i i
~ M c "~,,' 'I,il
'JII SINGLE FAMILY I.Jll NEWSTRUcrURE &ZtIJ.s /rm:e,il/ ~4",(!fIl 8 7006 I,: Ii
o TOWN HOME 0 ROOM ADDmON(S) Plumber's Indiana State License #: Ii U!
o TWOFAMILY ", '" i~_.
# of units; ES ~~~~~:~DmON(S) (oq(, e:x:>p {J.Lf---------J
o MULTI-FAMILY 0 ACCESSORY BUILDING Which plumbing codes wlJ!.!!!!..!p'plied to the construction:
O # of Units: 0 DETACHED GARAGE ~ International Residential Code w/lndiana Amendments
RESIDENTIAL (For 0 ATTACHED GARAGE
Additions, Remodels, Etc,) 0 DEMOLmON 0 Unifonn Plumbing Code w/lndiana Amendments
(Multi-Family Construction Code)
ZONING:
~ - I (3,DcCA
~l2.l
ECTION
xr
o
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PROJECT INFORMATION:
Early Release ./ Manufactured ./ f9lINDATION TYPE: (Check all that apply for the new
Permit: Y VN. Trusses: Y...k:::....N ~U:;ti?~_)ilre'il)r-::\ ~:"'!":-qllr.
Lot Spl'lt', Y V<N Sump Pump'. ~Y .:i:Zi '-m.J B' CRAWq>PACI> ..,:, ,:cQ ",Pgs;J;,,1lI B~QN
JL.' --;:+;I' ~ Q.. SLAB,I "I~:{> 2"(0 I-,~" ,BASEMENT Ions
Does any part of the property lie within a special Flood designatio 'rfte,~'=--:' Ci Y;~N lJ,\!. i-\:;.;y~Lk,9m: YLN
For Single Family and Two Family dwellings, additions, remodels, and/or accessory stru'ct~r~'tiil~~~brtk i'~ (;'ilid:pply'i[JVV:~~!f~:nnmences
within 180 days of the date of issuance oE the building pennit, and must be completed (Certificate Of,QtS~l'~Cy, issued) wiUriri'1S M.onths of the
issuance date. Class I structure permits are subject to the General Administrative Rules of the State of Indiana I (Sci: 6751AC 12) regarding expiration
time frames for beginning and completing construction.
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 LC. 36N 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 un . a Certi/icate of Occupancy has been issued by the Department of Community Services. Carmel, Indiana.
Signatu of Owner or Authorized Agent Print ~I1'UJAlc:f ~oe H-L(,v ~
I Ira/ex;
Date
OFF1CEUSEONLY:*********************~*************************************************
'.f I. Filing Fees: j () (. (; - (i(l
INSPECTIONS REQUIRED: '\'1-'1 . I.:) /^ # Ch eel R
~ Base Inspections: . 6 ~ ,) u arg e-
~ Lowe~ Under Slab ol';l . ~/. -) V Reviews
_. . ~- t~rt, of Occupancy. . .
R g er Ba (final ~ (f<i.' P,R,LF,: (J.. GI 00 Additional Fees
VT~OTAb: ,/J.I ,f...--JC/(? ()6
~rtX&1;!;::f<i4<
. of Community Services
Fee Received by;