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City of Carmel/ Clay Township Permit #:0'70'2-0 II Z-
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER UTIlITY
PROVIDER:
FAX:
LLCONE:
'i"""V'\L
CITY:
STATE:
ZIP:
STREET ADDRESS:
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STREET ADDRESS:
CITY:
ZIP:
STATE:
, -.w l/C:t:>
ZONING:
SUBDNI$ION NAME:
SEmON:
LOT'#:"
( ,,'
ADDRESS OF CONSTRUCTION:
wt'O,-\f.t Ld lPL\
'Om
WI \Sa",- ~ ~~ r ~ ?x..u..::f/'I'
TAX MAP PARCEL #: 6,02..0111
NAME OF UTIlITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AN,~/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DES!
FOR THIS PROPERTY:
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TYPE OF CONSTRU TYPE FIMPROVEMENT:
/ 11\
QI SINGLE FAMILY ,NEW,STRUCTURE
o TOWN HOME "v.o ROOM ADDITION(S)
o TWO FAMILY '\- \ 0 ,PORCH ADDITION(S)
: # of units being (.~ pI'" DECK,ADDITION(S)
constructed at thi!(v /' 0 REMODEL
time: ",\ //" Basement Finish only
o RESIDENTIAL (For // 0 ACCESSORY BUILDING
"',\ "",' ,
Additions, Rem9dels;'Etc.l /' 0 DETACHED GARAGE
\ /' 0 ATTACHED GARAGE
PROJECT INFORM\TIOt{ 0 DEMOLITION
S
For Single Family and Two Family dwellings. additions, remodels, and/or accessory structures, t8uDj:eati\O.>auar&{ijlifQ~~1flPJ1...c"'W1ences within 180
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issuqg' S'ttW8 iBrmb~~th{J1Mtran<;e.~J,u~...Bass I
structure pennits are subject to the General Administrative Rules of the St,ate of Indian~ (See 675 IAJ;.uJ..r~aW.~fi~ai6.R~g and
completmgcon,tructwn, D~t-' \ vI- I ^V"T'nlNlIJ!l:HIP
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteratio~~,@Jtd5\MQ.q{ tC~f hfn'd"o't~f~~ures
requested by this application will comply with, and conform to, all applicable laws of the State of Ind~klaAd tile ~Zoning OlfW.'jH\,~el 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 amerl~~'e['eto, 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 used or occupied until a Certificate of
.mcyh en issued e D ment of Conununity rvices, Carmel, I diana.
Early Release
Permit:
Lot Split:
P UMB NGCONTRACTOR: ~CF<6'O~DlgL
:::rm r ..c:,.~' .ro..ciT' Oy ~ T
Plumber's Indiana State License #:
~\Olt4':J'lD ~1S(:u" 1111J fulrd
Whi;)-plumbing codes will be applied to the construction:
~ International Residential Code w/Indiana Amendments
o Unifonn Plumbing Code wI Indiana Amendments
_VLN
_v.0
Manufactured
Trusses:
~=~
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Sump Pump:
CRAWLSPACE 0 POST & BEAM PIER
~E(!l~~ N)
OFFICE USE ONLY: *********************************************************~** :"-*****************
F'I' F J 0 I ..J' l/
INSPECTIONS RE UIRED: I mg ees:
, . Base Inspections: ~ 1 '1, ~O
pper Foot'" ower Foot Under SlabS 3 50
~' -::::-J Cert of Occupancy: -
l"inal ~' ~ (p /. 00
'~
:J0D'ol
D.te
# Charged Re-
Reviews
c
2.-
Reviewed/Appr ved: Dept of Community Services (Date)
S:Permlts/Forms/ILP RESIDENTIAL
Date