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City ofCarmel/C/ay Township Permit #Oh030!)53
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
NAME
STREET
PROPERTY
OWNER:
NAME
STREET ADDRESS
LOCATION
& PROJECT
INFO:
LOT # J..:L, SUBDMSION NAME tl
ADDRESS OF CONSTRUCTION
SEWER UTILITY Il.
PROVIDER: V -rr.w 0
WATER UTILITY
PROVIDER:
NAME OF UTILITY EXCAVATION CONTRAcrOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); ANDIOR COUNTY WELL ANDIOR SEPTIC PERMIT #'S (IF APPUCABLE):
CONSTRUCTI N:
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
bn NEW STRUCTURE
(] ROOM ADDmON(S)
o PORCH ADDmON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOllTION
I
~
PROJECT INFORMATION:
Early Release .J Manufactured J
Permit: Y -b..-..-N Trusses: +-Y N
. -\I 'I. . - ~ CRAWLSPACE 0 POST & BEAM
Lot Split: _Y TN Sump Pump: -r-Y _N fJ- SLAB ~ ~ BASEMENT
Does any part of the property lie within a special Flood designation area: _ Y -A-N WALKOlIT:_ Y--1-N
FOUNDATION TYPE: (Check all that apply for the new
construction area)
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 (Cenificate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits are sub~ect to the General.Ad.ministr~r~~~,_~[.~~ ~& In,fflM~e;7rr1ac..uJ J'egarding expiration
tIme frames for beginnmg and completmg constructIon. \.: '.~ , ".:) . r ; L t...; I I U N
I, the undersigned, agree that any construction, reconstruction, enlargement, relofati&:n~:faltetati6h:bf.a'sttucture;oranY~charlglimids:: use of land or
structures requested by this application will comply with, and conform to, all applicable la~ of,t~~St~t~ 9f I.g9i~~,@4:th~~ ~Zoning Ordinance of Carmel
Indiana -1993" (Z-28?) and amen~ents, adopted under au~ority of I.C 36-7 et ~_q_e~er,al,Ass,eT?b~y .?f,~_~e,~~t~.o_f Ip~ AACl11lJ....6.ct~ am~datory
thereto. I funher certify at only kitchen, bath, and floor drams are connected tc? the'sanItary sewer.':'"l funher certify that th~ ~i,nIiiAictlon will not be
used 0 cupied until ertificat of Occurpancv has been issued by the Deh;rtni:rit.cif 'orimiliniiy.' Semces,.CahnelJ In;1.id-MH I P
. '"IOn' -@.~A~~A" . ~,,,~ J-Cj-00
Print Date
NLY:**************************~*******************~*'*I***~******************
FIling Fees: _(" ~ '\ 0
E QUI RED: , ' ./,
Base Inspections: DZ ;;: '7 ) () # Charged Re-
ReViews
Cert. of Occupancy: sl )'0
P.R.I.F.: /" /;;< 11 ~~ . .//Additional Fees
(-------;7/TO. ~AL: _ f!;/:;rf! J ()
//4??~J:/;/~G-
Fee Recelve<{ by: V
Under Slab
Fe
Site"")
Reviewe Approved: ept. of Community Services
S:PefmitstForms,lILP RESIDENTIAL