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CityofCarme//Clay Township Permit#: D~(j800!tJ
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
Nt{, I
PHONE
61
FAX
Ci
CITY Ca.
STATE
ZIP
PROPERTY
OWNER:
PHONE
FAX
STREET ADDRESS
CITY
STATE
ZIP
LOCATION
&. PROJECT
INFO:
LOT #
It)
SEmON
ZONING:
'S
03~
SQUARE . 0
FOOTAGE:f..c[QD 7
~()d.. .00
NAME OF UTIlITY CAV N CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL ANOlqR.?Eliri<; PERMIT #'S (IF APPLICABLE):
,_.'.,' ,.., '.
,-SJ '.ILr/
~MBING CONTRACTOR:
Y17 yYJ rt--. ~ns rY,c.
Plumber's Indiana State License #:
(If/ j()fXX)J() I
TYPE OF CONSTRUCTION: TYPE;OF'I~~'ROVEMENT:
- G "/ III III
V' SIN LE FAMILY, :.'~,:,>/0-NEW\:'l.i~VCTURE
o TOWN HOME, .:'';;':>' O.ROO;' ITION(S)
o TWO FAMI~k; \';/ C'$l\J~OR ONeS)
# of Units:'.'., I ~ 'l.D RE EL
o MULTI-FAMI~Y ~\l(O CCESSO UILDING
# of UClts: \ D ED GARAGE
o RESIDENTIAL ACHED GARAGE
Additions, Remo DEMOLITION
P
Which plumbing codes will be applied to the construction:
~ternational Residential Code w/Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi'Family Construction Code)
;r\ Manufactured ~
_Y ~ Trusses: ~_N
7.::\ ;C'\ 0 CRAWLSPACE 0 POST & BEA
Lot Split: _Y ~ Sump Pump: ~N 0 SLAB ~ BASEMENl
Does any part of the property lie within a special Flood designation area: _ Y --W WALKO
For Sjngle Family and Two Fami.hr.d~t>JI~~rlildFl" s~NSiaW~1. 'ry structures, this permit is valid only if construction commences
within 180 days of the date o~th.Hmi !wg€~r.qJftna!~ ~ule\ioo.Jileted (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structure$tdDi6ett-wsY~~P l:W&G 'Cenl~e.~mistrativc Rules of the State of Indiana (See 675 lAC, 12) regarding expiration
of Smtff: ~elstftWCYe mAl~a~eting construction.
I, the undersigned, agree that any~~r~tJN a ~tRf:i.Nlb'etatt~, or alteration of a structure, or any change In the use of land or
structures requested by this applidilmf WillY~~'r':L.W'~~~cJ~rq:@WN6bllews of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993" (2- 289) and am~toan~\::i\-R{~h\rtito O.c. 36~7 et seq, General Assembly of the State of Indiana, and all Ac:ts amendatory
thereto. I further certify that only kitchen, bath, and fl~~Dl onnected to the sanitary sewer. I further certify that the construction will not be
r occupied until a Certificate of Occupancy has been issue the Department of Community Services, Carmel, Indiana. /
Yl' eu ' 7 hiS/ex;;
Date'
FOUNDATION TYPE: (Check all that apply
construction area)
Early Release
Permit:
OFFICE USE ONLY: ** ******************* *********** ******** * *****?*****A**>f**************
Filing Fees: i12 ,)L, '/0
.'" INSPECTION~EQUIRED: . ., 2 7 <"11
~ ' L'_:--' .....-:: ,+;ftft) Base Inspections: j ~ _ d.Y
0!.Pper Foo~ ~er FOO~ Un~,~I,_a_~_---, 0 5".3. j(}
- ' ~ __.' - Cert, of Occupancy:
C RlliigiIJiV Ge~ FinaJ~ J 0/
P,R,LF,: 0'-
# Charged Re-
Reviews
Additional Fees
ReviewedjAppr ed: Dept. of Community Services
S:Permits/FormslILP RESIDENTIAL