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City of Carmel/Clay Township Permit #: () \e 0301 ru3
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, llr. Two Family: New Structures, Additions, Remodels, llr. Accessory Structures
BUILDER of N\';
RECORD:
PROPERTY
OWNER:
LOCATION
llr. PROJECT
INFO:
TYPE OF CONSTRUCTION:
p SINGLE FAMIIJ .
-f"K!OWN HOMF[)cUdtu0iJ
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
Q,-J'l'E\,\J STRUcrURE
o ROOM ADDffiON(S)
o PORCH ADDffiON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
c:<::R
FAX
ZIP
%03
FAX
STATE
ZIP
ZONING:
SQUARE .
FOOTAGE: d5 7 :3
,-
-I-n
Plumber's Indiana State License #:
(' P /OOaQ /7) /
Which plumbing codes will be applied to the construction:
~tematiOnal Residential Code w/Indiana Amendments
o Unifonn Plumbing Code w/lndiana Amendments
(Multi-Family Construction COde)
PROJECT INFORMATION:
Early Release I~ Manufactured /"
Permit: Y -6~ Trusses: ~N
- --=2'\ -7.\ 0 CRAWLSPACE 0 POST & BEAM
Lot Split: _Y ~ Sump Pump: _Y ---t:!Y ~StAB 0 BASEMENT /\
Does any part of the property lie within a special Flood designation area: ~.- - _y---,4/ -- --__,__JliI.~,LKOUT:_ Y--lJ!)
..-, . ".."""'7l?:::::: ,'-, e, '"_ '~'''.',"'_' _u
Fo~adld~4ndF€Jf~~MG~UQdi~remodels. and/or accessory strubk~rJ~;~'lliS,~~f'is~~~6riiii[~~A~~ru,', ~tion commences
Wfcl&n"ISo~1~rJ'(th~ ~ &iSSlliUlce 'Of~~~rmit. and must be completed (Certificate of Occupancy is'sued)""Yftjhi? il8 months of the
is~i&fit. ~~rlMc~rcrp~~Fs'a~~_s~1>j~t to the General Administrative Rules of th~r State of Indiana (See 675 lAC 12) reSarding expiration
of State and LOCr.t1 f.....-.~~;rJ.m.t;!wP~ for beginning and completingidJnstructidI1'\R ? L1 ?nr;r< I! I ! If
I, th~~~aMi.l\tr~oiiSiiVcti.on;fet'~Sl,n, enlargement, rdocation, or alteratib~ o,r a'~tructu,re, or any'changc;m ~e,'use of land or
stIuchit6 ~~tllP~ . ~pli~$qn wilJ-cqrNWf~fS~~nform to, all applicable lawil of ili~ ~~!~ of Indiana, and the "Zo~g.O~ance of Carmel
Inc(f..ahnl~"(3..2~ 'imerl~a\ioptea unCler authority of I.c. 36-7 et seq, General Assembly of theSt:ateoHndiana,anR allvAqs amendatory
"thereto. I further certify ~.AitdlAn, bath, and floor drains are connected to the sanitarY...~r. I funher certify that the construction will not be
~used or occupied until a Certificate of Occupancy has been issued h the Department of Co~munjty Services;Carm-::Jndiana. "I;:, vi
( ~ ' C Q-k' :.e ~/ nOvr a dB 'Of::;
Si ture of Owner or Allthorized Agent rint Date
OFFICEUSEONLY:************************************************************************
Filing Fees: ((2 S;1. 3. ()
INSPECTIONS REQUIRED: .. ~/1l
Base Inspections: ;L. (a "7 ~ v ' V # Charged Re-
U~~tin~wer Footing . !5: (. SO Reviews
~~ €r B;';::> Final Cert. of Occupancy. J /) ( n I . 00
".. _00 ) P.R.I.F.: ~ Le- ~ Additional Fees
'J. I ?-.30
FOUNDATION TYPE: (Check all that apply for the new
construction area)
~-'"3o-ob
(Date)
c "
_flJ....,.
Reviewed/Approv : Dept. of Community Services
S:PermIts/FormS/ILP RESIDENTIAl