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CALL A-1 EXPEDITORS {,
City of Carmel/Clay Township 695-35'14 P"ermit#: (J og(j/~I
RESIDENTIAL IMPROVEMENT !fiO(PA1JI(!)NRElR1MIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
SEWER UTIlITY WATER UTlU1'Y
PROVlDER'C ' S' 'p PROVIDER: C
NAME OF UTlUTY EXCAVATION CONTRACTOR; PlAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE): JD T I G-
PLUMBING CONTRACTOR:
--&.u..\ E, SMiTH
Plumber's Indiana State License #:
PROJECT INFORMATION:
Early Release / Manufactured /
Permit: Y ~ Trusses: V Y N
. - - -;r- 0 CRAWLSPACE 0 fiST & BEAM
LotSpht: _Y _N Sump pumlJ9S;...JL.Y ~N 0 SLAB /' IJ?' BASEMENT ~..::::...
Does any part of the property lie within a ~~ . designation area: _ Y LN W~l!S9~~~,~:qf"&; \ f\'
For Single Family and Two Family dwellings. a~ons. re.w~~.>-.~,<mry structures, this pennit is valld, Dl)1y\i&onkrfrdj~.~~es
WIthin 180 days of the date of issuance of t trifiC ~ 6e~P~J:ed (Certificate of Occupancy, ~ Within 18 momhs of the
issuance date. Class I structure pernuts are su e :A~W.e'1UJ1~f ~he State of Indiana (Seel~!S hAC 12) regardin~on
timef r . ~8.o~~g't.te9'!'ction. \\f\\ \ ~\lG 1)) wvv
I, the undersigned, agree that any construction, reconstructl, e , ~f1f~961roJ.....tructure, or any' ~~~ m ill'f1se of land or
structures requested by this applicatIon will comply WIth, and co o~, ~~ 0 s.utrof Indiana, and ~~~Zdmng Ordin~
Indiana -1993" (Z'289) and amendments, adopted under authonty~ 3'6~ ""C!, ~ Assem f the State of In .. ,J:na.aII-Acts amendatoty
thereto I further certify that only kitchen, bath, and floor drams are c~ftil~ ~~.te'F.:. I further certify that the construction will n~-
used or occupIed until a Certificate of Occupancy has been issued by the Npartnie\:i!f~~ity Services, CarmelJ~a.._______
.. . Loll.; A~;ll.b!':ON2~f.fENI;fIlE 8/;1t.,/Dlr.
Print Date
BUILDER of NAME
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
TY7 CONSTRUCTION:
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TY;;JJ;.IMPROVEMENT:
NEW STRUCTURE
o ROOM ADDmON(S)
o PORCH ADDmON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o AlTACHED GARAGE
o DEMOLITION
PHON
(3i 31./7-
-?31~
STATE
I
ZIP
4 ;1 ~
BEST METliOD OF CONTACT:
OLUS
SQUARE
FOOTAGE: 53
ESTIMATED COST OF CONSjl.UCTION:
(EXCLUDING lAND VALUE) iii J/3 ()iJ0
I
0/100
IOi?'7'?
Whi~lumblng codes will be applied to the consb-uction:
(!i'( International Residential Code w/lndiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
~i\
\
OFFICEUSEONLY:*****************************************************~******************
Filing Fees: 9',2 0 (JO
.. SPECTIONS IRED: .~ 2 :S 0
. Base Inspections: --/ 7 # Charged Re-
Under Slab .r- RevIews
Cert. of Occupancy: .:> 3. 50
G. (/
O<.S /J., (}O'
Site
I
Reviewedl oved: Dept of Community Services (Date)
S:PermIts/FormstILP RESIDENTIAL
Additionai Fees