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City of Carmel/Clay Township Permit #QkQ1.12I3Q
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
A
~ / FOUNDATION TYPE:
. Manufactured \..../' co~st ion area)
Y ifN Trusses: ~- N -
- - - - CRAWLSPACE
Lot Split: _ Y - Sump Pump: _ Y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _ Y A
BUILDER of
RECORD:
NAMY (
p
BUILDER'S EMAIL ADDRESS
1-COt{
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
o
o
o
o
P
Early Release
Permit:
FAX
z-'Z8
o.UJ7
7
PHONE
FAX
ZONING:
Sii
PLUMBING CONTRACTOR:
-C-ih\~~
Plumber's iiliijanaStatei,cense #:
~OOI)q~
Which plumbing codes will be applied to the construction:
O/Intemational Residential Code wI Indiana Amendments
~ Uniform Plumbing Code wI Indiana Amendments
(MUlti-Family Construction Code)
(Check all that apply for the new
o POST & BEAM
~SEMENT ~
WALKOLJT:_Y~N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences
within ISO days of the date of issuance of the buildin.s~9'.tp..}t,:!n.Q fTI,u~t. ~.l;; l=;('>fQp.k.t~CO;rfR9He of Occupancy issued) within 18 months of the
issuance date, Class I structure permits are s~fiiJ.b'eGenerar/.\ilministradve RulcS'&f't'he\sth~e of Indiana (See 675 lAC 12) regarding expiration
SOOl~e-tlT5s J~f!~,Qning-an(f~ompleti"g:.~hsthx'lSIO. ,
I, the undersigned, agree that any construction, rec~nstruction, eql'!Igc.mel)t, reLoclltion"or.a4eration of a structure, or any change III the use of land or
s~ctures requested by this applicationr'ill comp~ wi,th. &n~~~~~_f~rm' ~~,"~l ;a'p~~c'~?k~~~~~~Rf J:~~~ of Indiana. and t~e "Zoning Ordinance of Carmel
Indiana -I99r (Z~2 and amendment.s, adopt9lY.Qd.lf amliomY'of I:C:36~7 cr:seq; Gencl'aI\AH6nQ)"1>f the State of Indtana, and all Acts amendatory
thereto. r further rt"' that only kitch61, b~~~ra.in~.:.ar~so~ cttdQ'.9t.:!i'i ~riif<ify~~S~~ certify that the construction will not be
use c oc i til ~Arrte ortJcc~M!,J"lrtlee~-fss~ea ' t tmem orCommu;i~rr,,-ces, C.cmel, It.n.- I J a.r:.,~ rf7.e
~ n! rOwn. cAut nt Dat T
Filing Fees:
Base Inspections:
Cert, of Occupancy:
**~******~*****************
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-/
c2- 6 7 J (! # Charged Re-
/1. ./ Reviews
<5 , J 0
INSPECTIONS REQUIRED:
Upper Footing
~ghi;;) Meter Base
Under Slab
~
P.R.I.F.:
RevieweajApprov d: Dept. of Community Services
S:Permits/FormS/ILP RE IDENTIAL
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Additional Fees