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City of Carmel/Clay Township Permit #Cboq 0/59
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
NAME
v..t:.(,G.
Co>.:>"." :oc-~
PHONE
?\l d-'5e ~d4- I
FAX
PROPERTY
OWNER:
NAME
LOCATION
& PROJECT
INFO:
SEWER UTILITY
PROVIDER:
C-U\-?
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:"B....) an L "
o NEWST~Gf.. ~.q, ~ Ow....> " ',.J..:,' , me I
o ROOM ~ D f:, f!I- ber's Indiana ~t~te License i Iii:
~ PORCH ADDrn I(S'PrnpliEt tv ' " ' 0' , i ! r!
00 RE~~ StEttea, " 'I'
o AC BQ.cM."" nO\t\!j""Y ulilllillg.-Jes. applied to the construction:, LJ I :
~~T:JM' A Cij COrl... >dUfEttlOfll!, ,'--' I
o DCTAC ~~M 'v'ONJrf'nm6na' !l-esllIential Code w/Indiana'Amendmj'nts
25 ~~~CH~fo~ARA ,,~L /~llnif~~lIiC,lll&.!=l?de Wf]!IJ!Ii!!';!.AI11Emdm~I,-~_j
U ,vDIA,N4:(M~I;r~~~CtlDn Code)
PROJECT INFORMATION: ;;:;t1//:)
E I R I / Manufactured ./ FOUNDATION TYPE: (Check all that apply for the new
P:~~it:e ease Y / N Trusses: _ Y ~N construction area)
Y /N L 0 CRAWLSPACE D/POST & BEAM
Lot Split: {' r Sump Pump: Y _N 0 SLAB / m BASEMENT
Does any part of the property lie within a special Flood designation area: _Y 1N WALKOUT:_Y / N
TYPE OF CONSTRUCTION:
ex( SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
rit' RESIDENTIAL (For
Additions, Remodels, Etc.)
CITY
'?J 0>0.>.:> -.:>"C\';;,V G"
BEST METHOD OF CONTACT:
\).
PHONE
:,q BIB 6
FAX
L
STATE
\ \oJ,
ZIP
41oO '2>~
SEmON
ZONING:
s-\
Eo
SQUARE
FOOTAGE: \ ClCC>
WATER UTILITY
PROVIDER: C..b.~\):t:::.L
ESTIMATED COST OF coNSTRumq~:
(EXCLUDING LAND VALUE) 'It> \C\.. ~.~
,
\
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 ",ill comply with, 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 authority of LC. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
th eta. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
use or occupied until a Certificate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana. i
. I'G:.~-f ~_ 'h~\c:.. C\-dl -Olo
Signature of Print Date '
******************************************************************
Filing Fees: /--:::3 -3 , ')()
,
Base Inspections: / II. 00
Cert. of Occupancy: S3- SO
INSPECTIONS REQUIRED:
Upper Footing Lower Footing
0U9h~ Meter Base
/f/~' Atk/
# Charged Re-
Reviews
Under Slab
~
c1ina'
Additional Fees
(Date)
P,R.LF.:
r/. ~O;;X #" c?Y'#: aJ. .
~f(tL . ~) /~/q/tJb
I
Reviewed/Approved: Dept. of Community Services
S:PermitsjFormsjILP RESIDENTIAL