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City of Carmel/Clay Township Permit #:'{}ffloI33
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICAtION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
FAX:
PROPERTY
OWNER:
STATE:
LOCATION
& PROJECT
INFO:
SEmON:
ZONING:
5- J
IPS'';
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions, Remodels. Etc.)
ESTIMATED COST OF~CONSTRUGTION:- ~ r' \\ Ii' '.. ; :00 '
(EXCLUDING LAN~ Y~LPIE?~~i'~_.\~_:._:J..i.~- 'ot!?., i~
, " I j I ; j I " ~
l! ~~I !Ii 11'1
lit I! I f'ln HI! ,I
: I I 1 I j ~ l' I' I
TAX MAP PA~SELl.!; i ! tJ / I
I ' j'-'
I ,
TYPE OF IMPROVEMENT: PLUMBING CONTRACT2R:__ .-i/'J
o NEW STRUCTURE /01 '7'1 P'I J1 1',--;SM I ~
fi ROOM ADDITION(S) _ Plumber's Indiana State License #:
o PORCH ADDmON(S~
o DECK ADDmON(S)
o REMODEL . . I ~iCh pi bing codes will be applied to the construction:
Basement FiniS on y ,
o ACCESSORY BUILDING nternational Residential Code wI Indiana Amendments
o DETACHED GARAGE .. .
o ATTACHED GARAGE 0 UnIform Plumbing Code wI IndIana Amendments
PROJECT INFORMATION: 0 DEMOLmON FOUNDATION TYPE: (Check all that apply for the new
Early Release AI" / ~ Manufactured B construction area)
Permit: ., YN Trusses: yy 0 CRAWLSPACE POST & BEAM PIER
Lot Split: _y ~N Sump Pump: 0 SLAB BASEMENT (WALKOUT:_yAN)
APJ"lSs-r;NSTRifJ~J /Z.D_
~"o~I~~ll1Y v.J~Z/G-
SQUARE
FOOTAGE:
AT! CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
Sl; AND/OR COUNTY WELL AND/OR SEPTIC PERMIT ,'5 (IF APPLICABLE):
<1',4-
,
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid ouly if construction commences wi~ 180
days of the date of issuance of the building permit, an_t completed (Certificate of Occupancy issued) within 18 months of the issuance date. Cl~s I
structure pennits~e sUb.elmJe ~g.. . sof the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
ompleting construction. I
I, the undersigne a ' i , c truction, enlargement, relocation, or alteration of a structure, m: any change in the use of land or structures.
requested by this a catl n WI 1 comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana - 1993" (~>
289) and amendme , opted under authority of I.C. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, drai a end to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of I
Occupanc iss entolCo mtySernceS;-C I,Indi:::.r~<<A.Ic j,2J, -tJ (P I
Print Date I
OFFICE USE ONLY: ********* * *****:~*fj?.J****** **.***************.!)*S-*~**~6'*************'\o***
INSPECTIONS R UIRED: ' I.~ ~Ihng s. de. L I
~ 1 \ . ~ B e Inspections: / r:; C. S; Q # Charg~d Re-
~p~r FOO~ing) Lower Footing Under Slab , S-rJ Reviews
~:;~. Meter Base Final Site - J ~~ c;- -5
P.R.I.F.: ~ Additional Fees
~;Jb~1. Jrf
Fee Received by: Date
q-2 '
(Date)
I
Reviewed/ Appr ved: Dept. of Community Services
~ S:Permits/FOI'TI1slIlP RESIDENTIAL
~