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City of Carmel! Clay Township Permit #: 070/ 0075 /
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, S. Accessory Structures
PROJECT INFORMATION:
Early.Release /' Manufactured, /'
PermIt: Y V~ ^ Trusses: V Y N
- - v<- 0 CRAWLSPACE 0 PO~k~EAM
Lot Split: _ Y _N Sump Pump: - Y ---=~~.: OR cON~OOgi!Ml!NT
Does any part of the property lie within a spec~al,~o~i1~~? ~ F in~ith ail re_~:
For Single Family and Two Family dwellings, addi[ioris,\ier'1;~de~~hdnia~cessory sd~' ~Hr~'0'".' mwatuction commences
within 180 days of the date of issuance of the buildi.~g ~~rkit, and must b.tj:1 ' ." .hp~..l ' ~~8 momhs of the
issuance date. Class I structure permits are sub~ect t~ ~f<CPfner~44p1iqiS les 0, . . pf re~.. ..~ef~ tfgarding expiration
. tIme frt~~~ f<?f be~lM'i1g 1n . ig I 1../ ,\T. , , \' r" .
I, the undersigned, agree ~hat any co.nstru.crion, recon~trpqtH?4,:e.n1argement, relocatIOn, ~:v~j~atiO~ 4N~or any change. m t.h. e ~<~~,f land or
structures requested by thIS applicatIOn wIll comply WltH,Ynduqmfarm.to,.all.app!tmle'l . f the ~fate of Inql~na, and thn~Z0m~g Ordinance of Carmel
Indiana -1993" (Z~289) and amendments, adopted underlauthority of l.c. 36-7 et seq, General Assem~ly of the Siate."of IndtJnaX\nd"all Acts amendatory
thereto. I further certjIy that y kitchen, bath, and floo~~fQ!}nccted.to.rhe.saD.it~fY'se\"t'er. I further certify that the construction will not be
used or cupied un il a Cer 'cat f. ccupancy has Iieen issued b Department of Communit Se ices, Carmel, Indiana. --1- iO{) 7
Date 'f-
BUILDER of
RECORD:
NAME
PROPERTY
OWNER:
NAME
STREET ADDRESS
LOCATION
s. PROJECT
INFO:
LOT #
L
ADDRESS OF CONSTRUmON
SEWER lmLITY
PROVIDER:
NAME OF LfTIUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
F ON R
SINGLE FAMILY
TOWN HOME
'TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc,)
F IMPROVEMENT:
NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
STATE
ZIP
SEmON ZONING:
SQUARE I ID II
FOOTAGE: '1 1
ESTIMATED COST OF CONSTRUCTION: 130 ...r.vl
(EXCLUDING LAND VALUE) ex (J....LJ
'i~~
Which plumbing codes will be applied to the construction:
j8(lntematlonal Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
y~
OFFICE USE ONLY: *******************************************~~~****~*******************
Filing Fees: '-1-'1-3, /0
INSPECTIONS REQUIRED: . '7/17. :'0
-_._~ ;;::;.') Base Inspections: <:7. /, L
(lJpper Foot!.'!!I>~er FOO~ Under Slab 53 sO
(R:';ghIn~,terBavel.. y Cert,ofOccupancy: (d ~/ Or)
'= . . P,R,LF,:
_ . T~L:c2f,j'S:/O
c.~' q M J S-J--./ 1-1?'-o1 . 2
Reviewed/Appro\ted: Dept. of Community Services (Date)
S:PermitsjFormsjIlP RESIDENTIAL Fee Received by:
# Charged Re-
Reviews
Additional Fees