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City of Carmel/Clay Township Permit #OloCY] 0039
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
PHONE
'J gF-09~ 9
FAX
7g~-~.5,;)d-
STATE
:5t.
BUILDER'S EMAlL ADDRESS
PROPERTY
OWNER:
NAME
C c.f/S
FAX
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
OTY
..=J:Nd. I ~
STATE
.:::r: N .
ZIP
~.;; [?O
LOCATION
&. PROJECT
INFO:
SECTION
ZONING:
/
WATER UTlU1Y
PROVIDER: ~e ""^
NAME OF UTlU1Y EXCAVATION CONTRACTOR: PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS: TAC DATE(S): AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
JUL 1 2 2006
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
R!f ROOM ADDmON(S)
o PORCH ADDmON(S)
o REMODEL
o ACCESSORY BUILDING Which plumbing codes will be applied to the consttuction:
o DETACHED GARAGE 0 International Residential Code w/Indiana Amendments
C M. ,....~~NALO Uniform Plumbing Code wI Indiana Amendments
UJI'lPllI:I'lnnilQtJV (Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release .~ / Manufactured
Permit: Y ~N Trusses: _Y---tfj)
- y" CRAWLSPACE
Lot Split: _Y --Ifj Sump Pump: _Y ~ "p SLAB
Does any part of the property lie within a special Flood designation area: _ Y -----C1D
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o POST & BEAM
o BASEMENT
WALKOUT:_Y
(!'B
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction co~mences
within 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
time frames for beginning and completing construction. '
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or
structures requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and t~:ZQning Ordinance of Carmel
Indiana -1993" (Z~289) and amendments, adopted under authOrity of I.c. 36,7 et seq, General Assembly of the State,ofinmana, andili-Acts amendatory
thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I furthe certify that the constru'ction will not be
used pied until te upancy has been issued by the Departrne f Community S . ces, Cannel, Indiana.
1
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Filing Fees:
INSPECTlONS REQUIRED: -, ..., ..,. /16 # Charged Re-
C06a!i..EDRnsPeC;!:CTiloOnsN: ~ --- U
~per FO~-::> Lower Footi,ijEL INST UCT -rJ ~O Reviews
S rnpliance v,~IAfeg(K~m;v: J _..-:>
~ugh In'-:::>Meter Base inal 0 .sr,1d Locp!Iff.F~S' Additional Fees
OF COMMUNiTY SERVICES ~
J '..u-. ot. CllY OF CARMEL / CLAY TO~S~AL: tiZ~ _ c2rP
RevieWed;AP roved~ of Community selVice;O (Dale) IANA ~O v ~ f}-, -
S:Permlts/Fonns/ILP RESIDENTlAl Fee Received by'
e '1/ l'7/oft, S t:6"