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City of Carmel/Clay Township Permit #: 070J/)f~1
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:
NAME: Cur+ M C Uf+-S PH'3Ei7_ '89 ",-3foI5
iE78i~s oovtfouJh J. XX/,kSl.lilk
n I J \ J BEST METHOD OF CONTACT:
v-fS ~ f1,DT M41\.CO .
BUILDER'S EMAIL ADDRESS:
d4I- Cur--/-
NAME: /1
J~'
STREET ADDRESS:
/79/
LOT #:
254
FAX:
gfo i- 5/1.0 '5
STATE:
ZIP:
4~ O~ 2-
J'1~7o-a(, 15
I:
PHONE:
FAX:
Dr.
SUB7m~AM~o.{' We~+CI
ADDRESS OF CONSTRUCTION:
l'l'f .1- (!,ur las,,>
~"'Lil1Jf; 11,,;
: 89~DOO.~
ON CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
ND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):J (J
FLOOD ZONE AREA DESIGNATION(S) '~L _ .1 . .
FOR THIS PROPERTY: ')(-.:>"lll&e.u
TYPE OF CONSTRUCTI N:
0' SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels, Etc,)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
y j N
Y~N
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM AOOITION(S)
o PORCH ADDmON(S)
o OECK AODmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILOING
o OETACHEO GARAGE
1;&1 ATTACHED GARAGE
o OEMOLmON
Manufactured
Trusses: _Y ~N
Sump Pump: ~Y _N
PLUMBING CONTRACTOR:! i
IVr",e... ~ Ri;ck'e.1;
Plumber's Indiana State License #,VlAR
.:J:I: /05 a, '2,.qp-/
1 ~ /'007
,).J:
..-.., _../!
,
Which plumbing codes will be applied to the construction: j
o International Resid;~tiarCode-w/Indiana<Amendments_ J
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o
o SLAB
For Single Family and Two Family dweJlings. additions, remodels, ~d/or accessory structures, this permit is valid only if canst tion
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within IS months 0 ance date. Class I
structure p~nnits 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 will 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 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, 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
Occupancy has been issued by the Department of Community Services, Cannel, Indiana.
&d~ ~ Cur-+ /Vt. Curts 3//10107
Signature of OWner or Authorized Agent Print Date
P,R.I.F,:
# Charged Re.
Reviews
Additional Fees