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City of Carmel/Clay Township ~l.- ,~~ Permit #~5
RESIDENTIAL IMPROVEMENT LO&;'ION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New
BUILDER of
RECORD:
NAME
(J-eqr'
Accessory Structures
oft
SA..,;
Ji7-~- .
BUILDER'S EMAlL ADDRESS
PROPERTY
OWNER:
NAME
LOCATION
&. PROJECT
INFO:
SEWER UTILITY
PROVIDER:
MPR V MEN :
STRUCTURE
ROO ADDmON(S)
CH ADDmON(S)
REMODEL
o ACCESSORY BUILDING Which plumbing _es will be applied to the construction:
o DETAC~I~M!\"l:lED FO FitC~lial,J.,~~tial Code w/lndiana Amendments
o ATTAC"",n:~' GIt!(Jmpll!\~e Wl~ all r~ulatlons
~MOUTI''''''''O.' ",'....j. .' .U,m'l"Jl.P. bingCodew/lndianaAmendments
~ V~ " _.,'~! ~talo arm qMII o'f'a'lrll (:.o~n Code)
OEpr OF COMMU~JITY S RVIl.it:~
ManufacturedOITV OF CARME s I~heck all that apply for the new
_Y _N Trusses: _Y _N INO
WLSPACE 0 POST & BEAM
Lot Split: _Y _N Sump Pump: _Y _N 0 SLAB 7 0 BASEMENT
Does any part of the property lie within a special Flood designation area: _ Y _N b WALKOUT:_ Y_N
PLUMBING CONTRACTOR:
o
o
PROJECT INFOR
Early Release
Permit:
For Single Family and Two Family dwellings, additions. remodels, andlor accessory structures, this permit is valid only if construction commences
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 strocture permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 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 oHand or
structures requested by this applica' will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Cannel
Indiana -1993n (Z~ 289) and amen ents, adopted under authority of LC. 36~ 7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify t to kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
u upie n' Ci ate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
.. .r;~f{ri l/tNS j-d-1-0k;?
Print Date
OFFICEUSEONLY:*********************************************~~***~~*p*****************
Filing Fees: /,g. ;/..) .
INSPECTIONS REQUIRED: ( <3' _ /,'.) # ~ ed Re
Base Inspections: / _.:, L u ,arg -
Upper Footing Lower Footing Under Slab Reviews
Cert, of Occupancy:
~ P,R,LF.:
Rough In
-Meter Base
Final
Site
Additional Fees
u
/
./
Reviewed/Approved: Dept. of Community Services (Date)
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