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City of Carmel/Clay Township Permit #: Ob050/5'j
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
NAME OF un CAV TIO CONTRACTOJ~{P1.f\N COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); lOR COUNU'Wtcl-AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
/~ \\ ,"\
TYPE OF CONSTRUCTIONt;i\ .~~ " F IMPROVEMENT:
~N~LE FA t~\\>/ \'
.;;:,,\'/:.Y .
TOWN ~. \. J);:> (()
OW ~ \t;n.sr::~/ i)l\l PO CH ADDITION(S)
~\g'\ts: "v ~ ~ DEL
o MIJ~~ ,IL Y ~'*' CCESSORY BUILDING 'S~h plumbing codes will be applied to the construction:
# O~, DETACHED GARAGE Intemational Residential Code wI Indiana Amendments
o RESIu~\'I; (For /" 0 ATTACHED GARAGE
AddltIO~';f s, Etc,V 0 DEMOLITION 0 Uniform Plumbing Code wI Indiana Amendments
\- ./' (Multi-Family Construction Code)
PROJECT INFGRMAneN:
Early Release \'/yQ' Manufactured 6 FOUNDATION TYPE: .(CheCk all that apPI~~or hen w
construction area) . .
Permit: Trusses:_N
AO \ /7\ 0 CRAWLSPACE 0 POST & BEAM
Lot Split: _Y ---v Sump Pump: ---8L--N 0 SLAB ----"& ~ASEMENT
Does any part of the property lie within a special Flood designation area: _ Y 0 WALKOUT:_ Y G
BUILDER of
RECORD:
6t6-~3/'f
BEST METHOD OF CO~ACT:
. c..ovn '- -
PROPERTY
OWNER:
FAX
CITY
STATE
ZIP
LOCATION
& PROJECT
INFO:
LOT #
10
~i
SQUARE~
FOOTAG~
60/5g
~
Plumber's diana State License #:
c..j/ / tJa?O / t5 /
For Single Fam. il. y and Two Family dwe~.I.J.'~n'i: s, ~ i\dW~I1ftr'.~' and/or accessory structures, this permit is valid only if construction commences
within 180 d}u:.~'\ll1).~t:di~~~:lldI'k'lt~ ,a,Rd must be complctcd (Certificate of Occupancy issued) within 18 months of the
issuance date. ':~mr'e Rfp~e5=-'W1ttif:6il:<<I1l SI'1PAdministrative Rules of the State of Indiana (Sce 675 lAC 12) regarding expiration
:subiect to ~C> CS\i~S for beginning and completing construction.
I, the undersigned, agrec d:Dfi:€iit. ,.tt~OOcb~m. . 'r~ ". 0 l~"JA..9'... ffi. .ent, relocation, or alteration of a structure, or any change in the use of land or
, strucrures reqUeSK~if'Mlpc=1b1!lftY"'~ricfCO .'. ' all applicable la\vs of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993" (~~d1.me a '. ef(i)W .J><.;..."",!:)36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I furth~~..~ ;.'~ oar drains a,re conneered to the samtary sewer. I further certify that the construction will not be
occupi~~'"ntil a Certifi,cate ~ " , has been issued he Department of Community Serviccs, Carmel, Indiana.
- S/t'7/o?
Date
, ~.
OFFICEUSEONLY:***********************************************~~* ********~***********
Filing Fees: _ 2n
~ECTlONS REQUIRED: . O.....-c
~ - --g? Base Inspections: J '1 7 ) () # Charged Re-
U oting Lower Footi '-../ ~ - ~ <",/1 ReViews
-- . Cert. of Occupancy: )'3 . ..J v
ROiijjJi"In) Met Base inal Site / ;2. ~ . .
~ P'R~J.F.: T~OTA" . ~.;S;z:;;ees
'5-2'.7-06 ~ I. / /'
Reviewed/Appro d: Dept. of Community Services (Date) . . ___ ~ ~
S:Permits!formsjIlP RESIDENTIAL Fee Received by: