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City of Carmell Clay Township Permit #:()/:/)6o:)3$
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, 8< Two Family: New Structures, Additions, Remodels, 8< Accessory structures
BUILDER of
RECORD:
PROPERTY
OWNER:
LOCATION
8< PROJECT
INFO:
FAX
SE3N
ZONI~ _
SQUARE ,
FOOTAGE: 5;)3
ESTlMATED COST OF CONSjJ<UcnON:
(EXQUDING LAND VALUE)" J
COMMISSION I BZA I BPW DOCKET
R SEPTIC PERMIT #'S (IF APPUCABLE): I
PLUMBING CONTRACTOR:
Vn 11 j L ,-<Sm ;th
Plumber's Indiana State License #:
-J[2/ 7'7 7
/' Manufactured /
_y ~N Trusses: VY N
,/ ~ - 0 CRAWLSPACE 0 POST & BEAM
Lot Split: _ Y -lL.N Sump Pump: Y _N 0 SLAB ~ BASEMENT
Does any part of the property lie within a special Floo ignation area: _ Y A WALKOUT:_ Y ~
For Single Family and~~~~. i onS'f~' 6Mlcndior accessory structures, this permit is valid only if construction commences
within 180 days of file ~c;..~~a~~~~h6~Uiia lJlHe , and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class R; tBYre 6f~~~@C&.\ a.~ ~ral ~~trative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
. . i l~f'l"l'e@liiffiog\Mlti~nd completing construction,
I, the undersigned, agr~40'1\i1~~~H~<<dns~c;.tjOlf,~l~ocation, or alteration of a structure, or any change in the use of land or
structures requested b ~~J\~Jfy Q.~d cMtb~ t~ ill applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana -1993" (Z~28 ~~ts, a ~4t'iAAfl'iluthority of LC. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen, b , rlM110or'drains are connected to the sanitary sewer. I further certify that the construction will not be
used or occupied until a Certificate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
. .
o
o
Early Release
Permit:
Which plumbing codes will be applied to the construction:
~temational Residential Code w/lndiana Amendments
o Unlfonn Plumbing Code w/lndiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
LDe', A. B',Jl.hSOrJG-lloo:lIl€
Print
fD/Q'ltlot,
Date
OFFICEUSEONLY:*********************************************t>*****:*******************
Filing Fees: L/~,.,zg
INSPECTIONS REQUIRED: . '-9 ~ ~ # Ch ed R
Base Inspections: ~" _ ./ L arg e-
ower Footing Under Slab /"..", .t: 0 ReViews
Cert of Occupancy: L ,J ./
~ P,RJ.F,: ).;L hi 00.
, 1/ c:2S 0 ,cJ-tJ
7...,
Additional Fees
('V'/9-.-I~I~ '-r-<F;-oh
Reviewed/Appro ed: ept. of Community Services (Date)
S:Permlts/Forms/ILP RESIDENTIAL