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City of Carmel/Clay Township Permit #D703~1~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICApON
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
FAX:
7ff .-;ib.7t>
BEST METHOD OF CONTACT:
:S . C041
~E3 ;DRES~4!"..01~#
PHONE: FAX:
5'7o-ePl-?o
c~ '/L::3JY
ZIP:
?C-
PROPERTY
OWNER:
PROJECT INFORMATION:
Early Release yManutactured
Permit: _Y _Lt(' /'" Trusses:
Lot Split: _Y Sump Pump:
TYPE OF IMPROVEMENT:
o NEW STRUCTURE '1-/
o ROOM ADDITION(S)
o PORCH ADDITION(S) ~lll
o pECK ADDITION(S) Z,....J\~
~ REMODEL r 0"
Basement Finish
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
ZONING:
5-1
SQUARE ",?Utf
FOOTAGE:~ .
LOCATION LOT': SUBDIVISION NAME: SECI10N:
& PROJECT
INFO: ;'3RESSO&'J:7 'vt! e;,AA'L-.
SEWER UTILm~ /J WATER UTILm AI! /7
PROVIDER: :l!?7Jt<:L/ PROVIDER: (Y7/~
NAME OF UTILm EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT ,'5 (IF APPUCABLE):
.~?
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
:H ; j'
~! ! i!
-:I/1i
jL~/ j
"-."-~__.,_v _ nJ I
,
...."7.._-_J
I".
TYPE OF CONSTRUCTION:
GJ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
~~~NTIAL (For
Additions. Remodels. Etc.)
Which plumbing codes will be applied to the construction:
o International Residential Code w/lndiana Amendments
I
o Uniform Plumbing Code w/Indiana Amendments
_Y~
_Y -..0
FOUNDATION TYPE: (Check all that apply for the new
construction area) . . ~
o CRAWLSPACE ?~~~BEAM_PIER
o SLAB ~~S.\'{Ii.~'t.~'bUT;'. Y ! N)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory stru~t . ~-.,a\lM.\~~&Rs~_ s wi~hin 180
days of the date of issuance of the building permit, and must be completed (Certifica 't:U-P'\!f~ Ut;~~~l3.~tg'&"\h~ . ," ate. ~lass I
structure pennies are su~ect to the General Administrative Rules of the S~ate of Indian ,~t~~~~~~~ " es for beginning and
completmgconstruct ".: , _C cO I G\r
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alterat.w~a~ctu~~2~ha Ii the use of land or structures
requested s app lca' will comply with, and conform to, all applicable laws of the State ~.~(!}~l2b1i' l'ce of Cannel Indiana -1993" (Z'
289 amendments, ad ted under authority of LC. 36,7 et seq, General Assembly of the Stat.t:~.,ana all Act endatory thereto. I further certify that only
. chen, bath, and flo rains are nected to the sanitary sewer. I further certify that the cQk}uction will not be used or occupied until a Certiflcate of
Occupancyhas issued b artIDent of Community Services. J ~~A'1 344;;
Print Date
EUSEON Y:*********************************************************************************
INSPECTIONS REQUIRED: Filing Fees: /3). )" ()
Base Inspections: / If, 6 _ 7" 0
1,'-".<'0
Cert. of Occupancy: "') oJ ~
Under Slab
# Charged Re-
ReViews
- Final Site
P.R.I.F.:
Additional Fees
s 3~
roved: Dept. of Community Services
S:PermIts/FormsjIlP RESIDENTIAL
Date