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City of Carmell Clay Township Permit #: n to 0 \P OOS 0
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, 8< Two Family: New Structures, Additions, Remodels, 8< Accessory Structures
NAME
BUILDER of
RECORD:
NAME
PROPERTY
OWNER:
cm
STATE
ZIP
STREET ADDRESS
ZONING:
lOT #
LOCATION
8< PROJECT
INFO:
ADDRESS OF CONSTRUCTION
ESTIMATED COST OF CONSTRUcnON:
(EXCLUDING LAND VALUE)
SEWER llTIUTY
PROVIDER:
b
NAME OF lJTIUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUN"TY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
R en N:
SINGLE FAMILY
TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
. , [] RESIDENTIAL (For
I; ,.. Additions, Remodels, Etc,)
TYPE OF IMPROVEMENT:
~EW STRUCTURE
'-[] ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
~~ plumbing codes will e applied to the construction:
~ International Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
,,f PROJECT INFORMATION:
\.. Early Release /' Manufactured /
Permit: _Y LN Trusses: ZV Y N
. ~ - - 0 CRAWLSPACE 2/ POST & BEAM
Lot Split: _Y -IL-N Sump Pump: . Y _N 0 SLAB '1:>{. BASEMENT
Does any part of the property lie within a s designation area: Y LN, WALKOUI~~:::~ ~1
, . tl:.r:'l..c: ,', . 1,.--,. r.? r,,-' IS II \\if lell \\1
Fo~ Sl?gle Fa__: . ~~lty 1 11 u.~;ot~'l and/or accessory structur~s: thiS per~t~\v~illi!y;}f ~~~~~ctlOn_COIDfPenc~s
Wlthm 180 da _ t s:.rpff~~~e Hm crmlt, and must be completed (CertIficate of Occu~Y-lssued)'Wltnln 18 month~Sftlt
issuance date. ." ~trucijJgBte'tt'O~09jbQQb'l 'Ii. _ . _ dm inistrative Rules of the State of In~\t !CC 675 lAC 12) regarding e . a .
. (' 9.!.~n;':'''''~^MI INP'(!l{tSiiiR..., ingandcomplctingconstcuction. \ .~ OMI; I
I, the underSigne~~an~~.h"CMn,.(l.C&l\JC~W ~t, relocation, or alteration of a struc " any JUl iJtl*- u~.(ijI'llind q
structures requcste ~~~f\MEtl.~~~th~ ~~ soh.form'ro;all applicable laws orche State of lnd I a, the ~Zoning Ordinance of C'
Indiana - 199J" (e~ 9 a~ a~fujme~lolt'\iti.N,ts(1der authority of l.c. 36~7 ct seq, General Assemhly of the S ",. en atory
thereto. I further certify that only kitchtJn~~tn~ and floor drains are connected to the sanitary sewer. I further C 'rtify that the construction will not be
used occupied until crtificace of Occupancy has been issued by the Department of C munity Servic s. Carmel In
{
FOUNDATION TYPE: (Check all that apply for the new
construction area)
t1;-13 tX::J
Print
Date
OFFICEUS ONLY:**************************~******************~*l****~*}f***************
Filing Fees: :0 _ ~ ....L U
I!,!SPECTION,S REQUIRED: "'7 ~' &::"b
c c- ,':::---' Base Inspections: ~ --.J
~er Foot~ er Foo g Unde~ SI~b .5 ,.50
~~ Cert. of Occupancy:
Roug n ~ P.R.I.F.: / ?-..W 00
(J \(11 ;Q..I1I~ rn -(?-,ch
Reviewed/Approk,f: Dept. of Community Services (Date)
S:Permits/Forms/ILP RESIDENTIAL
# Charged Re-
Reviews
Additional Fees
TOTAL:
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