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CityofCarmel/C/ayTownship ~\-:yD~S permit#:OIaO:((J/)/ I
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
STllEET ADDRESS
Sllo
11-(,
PHONE
SlIS-rls5
.:rnJ:,ls
S\[AX. f I ~ 5
STATE ZIP
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BUILDER'S EMAlL ADDRESS
BEST MEniOD OF CONTACT:
Phc>>J<'
PROPERTY
OWNER:
NAME
C ttY""""'-
PHONE
'll't~ .
'1~1
FAX
LOCATION
&. PROJECT
INFO:
LOT #
cm
t- C'to',."J
SUBDMSION NAME C ) A
. afrne WOoCX
STATE
N
% 03.;2.
ZIP
tHan 1M
I
SECTION
ZONING:
SEWER UTI~
PROVIDER: u"-r-LI
NAME OF UTILm EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUmY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
".. L
SQUARE
FOOTAGE:
........":~\
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
.----;~'\
/"^ i ".'
~jV?
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TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
~ SINGLE FAMILY 0- ~RQqs:rURE
o TOWN_EASED FOR COQ)J~!?:~f1i~ON(S)
o TWO F lect to comp'i,lieee wQ:.I~.~~il ADDmON(S)
# of u. . '" Ie and LGC;CYOREM9~i;l.
o MULT1-~d~t ~FCOI\!iIViUt'HD{ :AEdEs1!~~U.ILDING
O # of UIIIU'- . c 'r;QJ.Y QEIAt1\ffIEDk3~GE
RESlD~W<<JliirCARMd- I . 0 ATTACHED GARAGE
Additions, Remodels, EtC.)iNDIA~ DEMOllTION
PROJECT INFORMATION:
Early Release Manufactured FOUNDATION TYPE:
Permit: _Y ~N Trusses: Y N construction area)
- ~ 0 CRAWLSPACE
Lot Split: _Y _N Sump Pump: _Y..i....N 0 SLAB
Does any part of the property lie within a special Flood designation area: _ Y LN
PLUMBING CONT
~ 1.
Plumber's Indiana State
Which plumbing codes will be app d
o International Residential Code w/lndlana Amendments
o Unlfonn Plumbing Code w/lndlana Amendments
(Multi-Family Construction Code)
(Check all that apply for the new
o POST & BEAM
o BASEMENT
WALKOUT:_YX-N
For Single Family and Two Family dwellings. additions, remodels, and/or 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 structure 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 of land or
snuctures 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 -199r (Z~289) and amendments, adopted under authority of 1.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 funher certify that the construction will not be
u r oc pied til ertm e of Occupancy has been issued by the Department of Community Services, Cannel, Indiana.
J;htv ~. ~r,.jHJ
Print
djd In/,
Date I
OFFICE USE ONLY: **************************************** *****~**}*****~*****************
Filing Fees: /~) $1 7)
INSPECTIONS REQUIRED: ( C/' v ~
Base Inspections: ') 3. -;, t # Charged Re-
- ReViews
Cert. of Occupancy:
Rough In
Lower Footing Under Slab
Meter Base Final c!!f;:J
Upper Footing
P.R.I.F.:
Additional Fees
T-oT~L~/ y: / /1 ~ ~
'-?/&cZ"dV r- ~G~(liA
'-, /
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proved: Dept. of Community Services (Date)
s{ILP RESJDENTlAL
Fee Received by: