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CityafCarmel/Clay Township Permit #: o707QId;3
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
,
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
I
BUILDER
OF
RECORD:
PROPERTY
OWNER:
NAME: ~ 1JJrt. AU.. ~ k't.tJLt-1 \.Ir. t.
,
FAX3n) <t6 ,.ol4l1./
PHONE31l) ~t. ~ So I
STREET ADDRESS: /l33~ l0>!th~&:Ll=hI'-~C~1e..~ I
BUILDER'S fMAll ADDRESS:
.....AvJrt<\U.r-el-W @.. (l~. Colll....
N71~on P. bb..--t\ 1\0
ST~EET ADDRES~ f'
It 5~D re.ro.bl"lll) It.. L-l12.Ut..o
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. . STATE: ZIP: IJ.-
W~!tlh"""0 :'-0n 'c./;f~-::O':tFr
;' It t..=..l ....,:::'/ t....::= U \J :,;.::;:::1, \ l'
BEST METHO?ltc TA8:e-------! I I \ I
II JUL FlxS 'lO07 II I
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PHONE:
,3n I 5'ib-lo'1S
'CAr~
: (~
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LOT #: jSYBDIVISION NA~: .
~ ~It~~~l 1~'L
ADDRESS OF CON1'\UCTION: . (I '
IDil-/-D Lro-Dlt.t..l.Ut'UL
SEWER UT1~ I 'L::> .
PROVIDER: L "4 l~lll1lAI
LOCATION
&. PROJECT
INFO:
WATER UTIUTY
PROVIDER:
ZONING:
SQUARE I ") In
fOOTAGE: d\ 'f
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) ',21). I b 13 ' In
[II h... ['(..lAVAt;
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:
'iE OF CONSTRUCTION:
SINGLE FAMILY
. 0 TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
-~
~P~ OF IMPROVEMENT:
Jl5. 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
TAX MAP PARCEL #:
PLUMBING CONTRACTOR: I .
..::j"i.Ol\\-dl... ?e. Rl.J.OO 11~ '
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
~ International Residential Code w/Indiana Amendments
o Uniform Plumbing Code w/lndiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area) !
Early Release ./ Manufactured '\." I
Permit: _V ~N Trusses: "V-V)'. N 0 cRAWLSPACE 0 POST & BEAM PIER
Lot Split: _V )(. N Sump Pump: L2-v _N 0 SLAB ~ BASEMENT (WALKO. t'~N)
For Single Family and Two Family dwellings. additions, remodels, and/or accessory structures, i.s ~rJP.\{ i!.~ ~~ 'g(rhF#o~~()~\iV?within ISO
days of the date of issuance of the building pennit. and must be completed'(Certuicate of Occu ~'iliPrYb\tt1. ~li~Hf i:b~,jffi!.l!Rce d~~~, CI~ss I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 67 6\~'r~$:~~fRf\2.0(iii\e fr1t':rlies fq~ and
__completiQ-gconstruction, 01 StiW~ ~ 1 tN.\1"{ ~l:..tl."_...,(ici.t....\\f'
I, the undersigned, agree t at any construction, reconstr;!s-tion;enlargement, relocatiqn, or alteration of a strucwrr.a~:~O~\n-1:h?Y~q,klaQg~Cjrtl!ll~\-M ,.,
requested by this applicati will comply with, andconf6rm to, all applicable laws of t < State of Indian~~ ~~&.Q,[ciift1lr.cel~lIIfdiana - 1993" (Z-
289) and amendments, ado ted under authority qf-fC. 36-7 et seq, General Assembly of teState of India\i'~4-al~<DPdi1RtMm~ p~:e~ef)XI further certify that only
kit en bath, and floor ns arc connected tothe sanitary sewer. I further certify tha the construcGb\Wi.lI'rt'ot be used o~~ltup.tM'l1hW a Certificate of
cup cyhas b n i d ~y the Depart~n f Co~u - y Se . es, Carmel, I "ana.
'/ I'J (It; /It.. 1/1& 101
PROJECT INFORMATION:
'L'
j, " ......-
OFFICE USE ONLY: ********1* )****7-*********************************~*O***********************
INSPECTIONS REQUIRED: Filing Fees: !) "3" ~:flO
~erFoo~ I{!fvier FO~ Under Slab Base Inspections: ;J:Z ~ () # C~::~ee:;s Re-
~ Fit ~----------, Cert of Occupancy: '. :J. .>
~Ugh~eterBa_-:..~nal Si~ P,R.LF.: /.) C (00 Additional Fees
TOTAL: I p" 3 / jI!j 60
c
, -'~15-
Dept. of Community Services (Date)
Date
S:Permits/Forms/ILP RESIDENTIAL
Date
Fee Received by: