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FLOOD ZONE AREA DESIGNATlgN(S}\ <;,\! ~ 0' \~\ \~
FQRTHISPROPERTY: /-:::\0~ ,y,,- \\\ \\\
TYPE Of CONSl'RUcTI:ON,/ f}!E OF."e1PROVEMENT:
~ING({FA~ir.y \ I(, '1) ~Ei.v STRkruRE
o TOWN HOM'~\\ ,~~ 9/ROOM ADPlTION(S)
o TWO FAM,I,LY;.'\ ~O PORCH'ADDmON(S)
# of urii~tb~i"g . 0 DECK ADDmON(S)
constructed at th,s 0/ REMODEL
. '\'" /
time: ~', ~ Basement Finish only
o RESIDENTIAl (For 0 ACCESSORY BUILDING
Additions, Remodel8:"Etc.l 0 DETACHED GARAGE
\/ 0 ATTACHED GARAGE
o DEMOLmON
FOUNDATION TYPE: (Check all that apply fOf~e ~wl
construction area) F()l.LF I tJ vJ I tyvr I ~
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB nvSASEMENT (WALKOUT:_Y ~)
~ "'--'~~-~ -
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid o>nlY',i~-ons~~~~i6~-c~rik~nces\:With!n 180
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 monthsof tl1e-issuanc"e-dilte.- CI~s I
structure pennits are subject to the General Adnllnistrative Rules of the State of Indiana (See 675 lAC 12) regarding expfration time frames for beginn~g~and:!
completmgconstructlOn II j \ 1 ! 1 n i i il
I, the underSIgned, agree that any construcnon, reconstrucnon, enlargement, relocatIOn, or alteratIOn of a structure, or apy:c~d~ge m Affite olla~ ~Qlctures I ; J I
requested by thIS apphcatlon wIiI comply With, and conform to, all applicable laws of the State of Indiana, and the "Zomng Ordmance 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 amendaJ:"2-ry~[iereto I further <;.ertlfy that only I
kitchen, bath, and floor drams are connected to the samtary sewer I further cernfy that the constructIon will not be used or occupIed untIl a Cernhcate 01.1 j
Occupanc has been ISSU b the DePi~m~nt of Cfmmuruty ServIces, Carmel, Indlana I 'I
/' r\bLCJ u.oANNF:: .;;;;f-IePf/GR-IS----tt rljO~r
s;9nature Print Date
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
City ofCarmellClay Township Permit #:~
,
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
NAMPllllf'
PHONE:
75-d3S0X
FAX:
061-77Q2
ZIP:
032..
1;;5
ER.IDfA
STATEJ
BEST METHOD OF CONTACT:
, C1JfY) E.J.-.I41L-
PHONE:
FAX:
cm:
STATE:
ZIP:
/.a
PLUMBING CONTRACTOR: . \
_f+1\rY1m q. -SDNS I
Plumber's Indiana State License #:
('PIMOI 0 ,
INt,
Whic,lumbing codes will be applied to the construction:
B'Intemational Residential Code w IIndiana Amendments
o Uniform Plumbing Code wfIndiana Amendments
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
Manufactured
Trusses:
''---'( _N
.......(_N
_yl/N'
-y-~
Sump Pump:
SEONLY:******************************~~*********************(5*01** ~~J*****************
INSPECTIONS QUIRED: Filing Fees: .>
_ ~. B I ct' '''J/1)1J
(Upper Foot; [ower Foot Under Slab ase nspe Ions: J (. ,1!: /;
~ r-- - -S'.,----... Cert, of Occupancy: /,':>. J ()
ough I <.. - -Meter aaie---- ~;nal _.!!L-.J / J.-. (,1 II ) ,
_t;J JL P/JJi P,R.I.F.:
Reviewed/Approved: Dept. of Community Services (Date)
# Charged Re-
Reviews
Additional Fees
6. Sf/
S:PermltsfForms/llP RESIDENTIAL
Date