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City of Carmel/Clay Township Permit #:()f:,,/)q 0101
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory St~uctures
1
1
BUILDER of
RECORD:
NAME
usr..J (1
",f jJJ .lA.A.-'d<a-,
606/
ZIP
STREET ADDRESS
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BUILDER'S EMAIL ADDRESS
PROPERTY
OWNER:
NAM~ _
..)/j7'J1c-
STREET ADDRESS
LOCATION
&. PROJECT
INFO:
LOT #
SUBDIVISION NAME
ADDRESS OF CONSTRUC}5'N / /J /
/2>ZtJ /lCOI1~ii7Z NJ,
SEWER UTILITY
PROVIDER:
tv'/T
WATER UTILITY /
PROVIDER: /lI / P
NAME OF LJTIUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKer
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'s (IF APPLICABLE):
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
o SINGLE FAMILY 0 ~ $;[.IJ,l.jq-IJP-E
25 ~~NF~~~LEASED FOR CfQ}lSi:OOM'AD~rt\~N(S)
# f . ubject to comp!'''.nce GZltil OORGHlAOOlllfbN(S)
o Un! . ,. ,_ .n'l ' '=1 (REMODEL
o MULTI-FAMILY 01 ",d." O. .\. L..= . . '.
# of unitSlEPT OF CO!\.i MUiQr,\Atq;:S~R.YlBlllLDING
O -l! 0 ^D6TAGHRq,G~E
RESIDE~Wl(grr CAfihtc Icj.J'ATIACHE'DtARAGE
AddItIons, Remodels, Etc.) \NDIA~DEMOLITION
PROJECT INFORMATION:
FAX
000
~:TE
BEST MeTHOD OF CONTACT:
3/7- (., - 2-7''1
'1t.a L
~ht1U
PHONE
FAX
CITY
STATE
ZIP
,
Ir
)1
:'~9~I~~j if
:Ii. '1':\ I>
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" .\1 itl 111
, I : 1 I 2 0 2006 SQI,JARE!
I! I \!: SEP ~q't:i'rf
\ U '-'I J'- 1
ESTIMATED COST.OFCONSTRU81ON:"" I
\EXCLUDING LAND VALUE) II!
. SEmON
1...-- __._.__
PLUMBING CONTRACTOR:
Plumber's Indiana State license #:
Which plumbing codes will be applied to the construction:
o International Residential Code wI Indiana Amendments
o Unifonn Plumbing Code wi Indiana Amendments
(Multi-Family Construction Code)
FOUNDA nON TYPE: (Check all that apply for the new
construction area)
Early Release /'-~anufactured
Permit: _Y _ Trusses: _Y _N
o CRAWLSPACE
Lot Split: _Y _N Sump-Pump.: ______No' 0 SLAB
Does any part of the prope In a special Flood designation area:
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences
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 permits 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 \vith, and conform to, all applicable laws of the State of Indiana, and the "'Zoning Ordinance of Carmel
Indiana -1993" (Z~ 289) and amendments, adopted under auth of r.c 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendat9ry
thereto, I further certify that only kitchen, bath, a flO<;;: drains are nected to the sanitary sewer. I further certify that the construction will not be
used 0 DC ied until a Certificate of Dcc ncyhas been issued b the Department of Community Services, Carmel, Indiana.
(V ,JdA n &ItA/MIs. 71b-21ft 3 q/N/OG
o ~ ~ Print Date '
/' ,
FleE USE ONLY: ********** ***~************************************************i******
- . Filing Fees: ,/33, of) I
INSPECTIONS REQUIRED: "'..,.- r :
Base Inspeqions: V u , G 0 # Charged Re-
A<>lJ:+io;ra.l6'h'ul'.l. qo 0 CJ Reviews
c&fl. Qt; O~rllp:::lnqc: 'L/l( : 0 .
Upper Footing
Lower Footing Under Slab
Meter Base Final e
Rough In
o
o
POST & BEAM
BASEMENT
WALKOUT:
N
y
Y
N
~
'.'H. . ~J!g;to ~~OO,,~
Fee Received ~