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City of Carmel/Clay Township Permit #: OttO'J...ODU
RESIDENTIAL IMPROVEMENT LOCATION T APPLICATION
For Single Family, Multi-Family, 8< Two Family: New Structures, Additions, Remodels, 8< Accessory structures
BUILDER of NAME ~ . .7;Vc..... PHONE '3 Wi; -lfJI~ (/~ FAX
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RECORD:
STREET ADDRESS jRJ) fiVE s: U/. .#(t{) em ~ATE ZIP
OJ {'/$tfAfEL ....vt- ' 3;--
BUILDER'S EMAlL AD-WSS 'ii . BEST METHOD OF CONTACT:
CfL.L .;l, 7-(PJ...7
PROPERTY NAME:+? ( ;/mss, PHONE FAX
OWNER: I/tJ5& MC
STREET ADDRESS em STATE ZIP
LOCATION LOT # SUBDMSION NAME SECTlON ZONING: 121
8< PROJECT 5'0 LltuM v/~~ }(E,S
INFO: ADDRESS OF CONSTRUCTlON SQUARE 3g2
II FOOTAGE:
SEWER UTILITY (A1
PROVIDER: IJ1fL
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
TYPE OF CONSTRUCTION:
i:iY" SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
a;:yNEW STRUCTURE
o ROOM ADDmON(S)
o PORCH ADDmON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
PROJECT INFORMATION:
Early Release
Permit:
Which plumbing codes will be applied to the on:
o International Residential Code w/Indiana Amendments
OQ. Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
Manufactured -X- FOUNDATION TYPE: (Check all that apply for the new
_Y VN 'R,J;o~struction area)
~ Trusses: _Y N t::l.... ....--., .
11 \I Sl'f; CRAWLSP/iti:-' ,,.Q__,p,OST & BEAM
Lot Split: _Y -A--N Sump Pump: --A---Y _N ""O':SLAB',C"::::", """,:CJ'" 'BASE_
Does any part of the property lie within a special Flood desi,g'Ftion ar'e,,~.,:,!: aY~N~' C;;~:,~~;WAU<:OOf:_Y_N
For Single Family and Two Family dwellings, additions, remodels, andJ~ccessory strUc~r~: i~s'p~riri'itilv~~p;nly ,if <ro~truction commences
within 180 days of the date of issuance of the building permit, and must be completed (Certificate 9fOcc_up'an~yjssu/ed) ,'widlin 18 months of the
issuance date. Class I structure permits are subject to the General Administrative Rules of the;State of t~d{an~ (See.67!j' ~--IRpegarding expiration
time frames for beginning and completing construction:' '.r\ I
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 apphcation will comply with, and conform to, all apphcable laws of the State of Indiana, and the "Zoning Ordinance of Cannd
Indiana -1993" (Z~289) endments, opted under authority of J.C 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I fun at only kite ,b th, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
u ed or occ ied u til Certificate (Q cupancy has been issued by ~epartment of Community Services, Cannel. Indiana.
J)Mr{) J . Lou.s.?ltE ,.)./(P/Ob:
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OFFICEUSEONLY:***********************************************~***********************
Filing Fees: '7) tJ, '70
INSPECTIONS REQUIRED: . '7 J i- (JO # Charg',ed Re-
~ Base Inspections: ?< _ ~
Uppe{Footin Lower Footing Under Slab ",-/ /'0 Reviews
~ - Cert. of Occupancy: ...., ~
Final Site~ P .R.I.F,: /;2 (, / (J ~ Additional Fees
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Fee Received by: