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cJJv Permit #: QCqr g 00(0 I
NT LOCATION PERMIT APPLICATION
ily: New Structures, Additions, Remodels, & Accessory Sttuctures
BUILDER of
RECORD:
PROPERTY
OWNER:
STREET ADDRESS
LOCATION
& PROJECT
INFO:
SEWER LfTILITY
PROVIDER;
NAME OF UTIUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TYPE OF CONSTRUCTION:
M SINGLE FAMILY
6 TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
cK NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL.
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
PROJECT INFORMATION:
Early Release
Permit:
FAX
ZIP
PHONE
FAX .....'::~..
""'-." '~",
" .
//
/0 ZIP
//
,// .'
Z070' -:.2..
F~~~~E 6~3;Z
CITY
"'"
37.
ESTIMATED COST OF CONSTRU}iJlON:
(EXCLUDING LAND VALUE) VI O?D'O all
PLUMBING CONTRACTOR:
Lf1T ~'
Plumber's ndiana State L,cense,#: .
/0 ;J{)m,71
Which plumbing codes will be applied to the construction:
~ntemational Residential Code wI Indiana Amendments
o Unifonn Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
)( Manufactured X
_Y _N Trusses: _Y _N
J y' 0 CRAWLSPACE
Lot Split: _Y -.L-N Sump Pump: ..,D>-Y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _Y )( N
~. POST & BEAM
~ BASEMENT
WALKOUT:_ y-X-N
For Single Family and Two Family dwellingv.iQ.iW..{l~~9l.od~~aPdlor access~~ structures; this permit is valid only if construction commences
within 180 days of the date of issuance of tlhCtallW~ltt~tfkB1nG;GNS;fptt6lo.clGN:ate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits are s%bSEtOUC lijom,PI~wtmimflt~t~ate of Indiana (See 6751AC 12) regarding expiration
time fra'l:l'rsg,.~ll.iffii'lld_fereRlfRf.g construction.
I, the undersigned, agree that any construction,flEefrlrUf-l\ien .wwr~ r a Ip.{l~,t..'ll~H~t.w~of a structure, or any change in the use of land or
structures requested by this application will co~~h,\.tnEl c 00 f~! Wl li a~Wd~ttate of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993" (Z- 289) and amendments. adc6t'l1\f1<@fiu0AiRMEL 3fC'f crewN5~f the State of Indiana, and all Acts amendatory
thereto I further cernfy that only kitchen bath and floor drams are fRW\t'f t e samtary sewer.''f further certIfy that the constructIOn WIll not be
used or occupied untIl a Certificate of Occupancy has been Issued tiy-tH4 rtment of Commumty Services, Carmel, Indiana.
~l!JJ2P1o?!..!J:J!lJ!.(.r <!(IJA/AlOAl H7NJ'/!;LJy.,,/ o:-/L/-()&
OFFICEUSEONLY:**********************************************'j~***********************
Filing Fees: z.,t'2.. ,:;z ()
INSPECTIONS REQUIRED: Base Inspections: 3/;"2 >0 # Charged Re-
Under Slab ~ () ReViews
Cert. of Occupancy: ;J S.J-.1 .00
P R I F ______Additional Fees
~. ., .: ~~ ;2 ,jOJ.j' e><V J
? ~/ 1'7o.0l..<::l ..
F. ecelved ~~:' ~
e~
I
Reviewed/Appro e Dept. of Community Services
S:PermitsjForms/ILP RESIDENTIAL
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(Date)