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City of Carmel/Clay Township Permit #:-30090013
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
PROJECT INFORMATION:
Early Release ~ Manufactured =i=
Permit: _ Y N Trusses: Y N
o CRAWLSPACE 0 POST & BEAM
Lot Split: _ Y Sump Pump: N ~ SLAB 0 BASEMENT
Does any part of the property lie within a special FI designation area: Y --G WALKOUT: Y @
Fo~ Si?gle Family and Two FJlIIlil~~~~itidi 51 !iC;;m~, and/or accessory structurc:s~ this p~~t,i~_v~~~ly-if-=-;~~s~S~i?!!-.<;o~ences
WIthin 180 dtia..@.~tilgf lSsV*f~gffR~:l>tdldllig1pt~nlt, and must be completed (CertifIcate o~ 9rc~\l~~y(~~~).W1~hin\.~8 ~91!F~~ of f~e
issuance date. Cl~i~~@f~~\ire ~1Jhj~8tQJAe Gel!.er.a.k'\dministrative Rules of the State of:lndia'n~(~~e_675.IAC 12).regarding:~~if~;tion
Su l \ State and LO '~~~ningandcompletingconstruction.i!I)! I 1" i l!
I, the undersigned, agree t~~~~~hhocdnstthqtQ..l}t>..~~{t1ent, relocation, or alteration of a Sn}llc_~~e\or any change in the llse,...of l~.~!orll\
structures reqUE~~lk11ti6h)Y.ill ~qm.'pI1\tyit1[Q\l'tb~rm to, all applicable laws of the State of Ip4ia:r1al and ~ p:oDill~ ~ce of ,qar;n?-~
Indiana -1993" (, <1dl.'b~Mtli,'ad.bp'tedunder authority of I.c. 36,7 et seq, General Assembly of thelState of Ina1hia, and an Acts amendatory; \
thereto. I furth . HUt oD1y kitcq<<\,\!)\oh.~floor drains are connected to the sanitary sewer. I furthet}Jdty thatthe c~~tion ~~riot be'l
u roccnpiednntilaCertificateorOccupancyhasbeenissued eDepartmentofCOmmnnitysetces.Cannel:lndia~~ _I.. . _I
75i--Lv . .,qCJUI . ~~fS;d 0
Date
BUILDER of
RECORD:
PROPERTY
OWNER:
STREET ADDRESS
LOCATION
&. PROJECT
INFO:
NlRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
TYPE OF CONSTRUCTION:
o SINGLE FAMIL~Y
~ TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
~ NEW STRUCTURE
d' ROOM ADDmON(S)
o PORCH ADDmON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
PHONE FAX
STATE ZIP
0)
BEST METHOD OF CONTACf:
C
FAX
CITY STATE ZIP
ZONING:
SQUARE
3~ FOOTAGE:~ '65
'0
Which plumbing codes will be applied to the construction:
~tematiOnal 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)
OFFICEUSEONLY:************************************************************************
Filing Fees: (p "1 1-/. In ()
IIII.sPECTlONS REQUIRED: ....,....., 7 _ r 0 # Charged Re-
~ , Base Inspections: ~o...L _ _...:;> _
l Uppe,:-Fo~ng~ Lower Footing ".un-crerSlali/ /' 3. __ 0 Reviews
~ Cert of Occupancy: ~ :l..
~h~~Qi_~_1 Site--=:> P.R.I.F.: I ;z.(Pf. 00
4" A? ft;&. roo
(j -1.J .()
re of Owner or Authorized Agent
Additionai Fees
'1'- ~ 0 b
(Date)
Fee