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City of Carmell Clay Township Permit #: f) 705'0/0&
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RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICAl'ION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
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BUILDER
OF
RECORD:
PROPERTY
OWNER:
NAME:
SL~~
STREET ADDRESS:
LOCATION
& PROJECT
INFO:
SUBDIVISION NAyE:l L L
WATER UTIlITY (I,. 'I.., (j
PROVIDER: LLlf '\\.Lx..-
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I 8PW DOCKET
NUMBERS; TAC DATE(S); AND/OR CDUNlY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
SEWER UTIUTY
PROVIDER:
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY;
TYPE OF.CONSTRUCTI N: TYPE OF IMPROVEMENT:
o INGLE FAMILY cd' NEW STRUCTURE
TOWN HOME 0 ROOM AOOlTION(s)
o TWO FAMILY 0 PORCH ADDlTION(s)
1IR8I.-,i!!A~ FOR CON~~~ON(s)
tC~I:l&IM~al1\'iJ!ianc'l with~11 ~Q.qlr3ns .. h I
Ime: , . 'fia"sement FIniS on y
o REsIDENTlA'CI(fGjlle and LocllI iITd~EssORY BUILDING
AddlilliiiS;JIl.&iO~1@ /itMU i'J!T'OS fim/:lBEifGARAGE
CITY OF CARMEL / CLpgTA~~_RAGE
PROJECT INFORMATIq~IANA be
Early Release Manufactured /.
Permit: _Y ~N Trusses: _Y ~
Lot Split: _Y ./ N Sump Pump: _Y_N
PHONE:
FAX:
CITY:
STATE:
ZIP:
SECTION:
ZONING:
SQUARE
FOOTAGE:
ESTIMATED COST OF CONSTRUcnON: .
(EXCLUDING LAND VALUE)
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PLUMB~G CONTRACTOR: _ ~
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Plumber's Indiana State License #: ' \
\0l1l1 ..,' \::.\ "
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Which.plumbing codes will be applied to the construction: '\'" \ \ '\
c3intemational Reside~i:ial:C~de w/lndiana.AiT'\nd,i.'~nis\ \
",. . \ ';.r . \"
o Uniform Plumbing.code'~/India~ j(\11end;"en~/> )
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FOUNDATION TYPE:, '(Check all that apply for ll1e new
" \," /'
construction area) \' ,..-__/
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Zc WLSPACE ','0 POST& ./BEAM_PIER
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SLAB 0 BASEI'!ENT.(WALKOUT:_Y_N)
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For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences within 180
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 IAC 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 Cannel Indiana -1993" (Z'
289) and amendments, adopted under authOrity of l.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 dra' are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occup~cyhas been issu the Department of Community Services, C el, I diana. , I L
- e i51~ 6 Ci 167
Print
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OFFICE USE ONLY: ***************** *******************************************Hr:J************** ** *
_::TCTIONS REQUIRED: ,-5~ Filing Fees: . t'-j }.., '7 ,-r
. . Base Inspections: '2. ~ 'J.., S D
Upper Foot, Lower Footmg Under Slab . ~5'. ~/'\
Cert. of Occupancy: ~''..J (;d
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Site
Reviewed/ Appr ved:
S:PermitsJFormsJILP RESIDENTIAL
Fee Received by:
# Charged Re-
Reviews
Date