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City ofCarmellClay Township Permit #: 070YD185""
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: C I
NAME:
~
WATER UTILITY
PROVIDER:
jl. fJ
PHONE:
FAX:
STATE:
ZIP:
4 ~ ~
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PHONE:
(3'
CITY:
CA
FAX:
STATE:
ZIP:
DEP
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PLUMBING CONTR#~~: LV IUd)
_PAtAl f. SM inl I I 1
Plumber's Indiana Sta~ license #: I
1017'17
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE
F CONSTRUCTION:
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of unjts being
constructed at this
time:
o RESIDENTIAL (For
Additions, Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_Y ..try
_Y~N
TYPE OF IMPROVEMENT:
rYf" NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
Sump Pump:
{:Y_N
~Y_N
Wh~plUmbing COdes will be applied to the construction:
M International Residential Code w/Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB ~ASEMENT (WALKOUT:_Y ~)
For Single Family and Two Family dwellings. additions. remodels, and/or accessory structures, this pennit is valid only if construction commences wit)tin 180
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. <;:Jass I
structure pennits 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 be:" issued by the Departm,ent of Community Services, Carmel, Indiana.
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