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City of Carmel/Clay Township Permit #: () 7 o,r:zrYl/ If
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Famil{~ ~SNew Structures, Additions, Remodels, &. Accessory Structures
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
rt;J TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Ete.)
BUILDER of NAME PHONE FAX
RECORD:
STREET ADDRESS Indianapolis, IN 46250 em STATE ZIP
ax
PROPERTY NAME FAX
OWNER:
STREET ADDRESS em STATE ZIP
LOCATION ZONING:
&. PROJECT
INFO: / SQUARE ~ 1 !J/-../~
FOOTAGE: .J
Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release
Permit:
Manufactured '^ FOUNDATION TYPE: (Check all that apply for the new
X construction area)
_Y _N Trusses: Y N
\I - Y 0 CRAWLSPACE
Lot Split: _ Y ~N Sump Pump: _ Y ~N 0 SLAB .
Does any part of the property lie within a special Flood designation area: _Y LN
o
o
POST & BEAM
BASEMENT
WAlKOUT:_Y_N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction comrriences
within 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months df the
issuance date. Class I structure permits 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 Chat any construction, reconstruction, enlargement, relocation, or alteration of a structure, or an~l<;bjlnge inChe,~67f land or
strUctures requested by this application will comply with, and conform to, all applicable Jaws of the State of Indiana, and ttlJJt:::onTng\()rf:firi.\ffice of Cirmel
Indiana - 1993" (Z- 289) and amendments, adopted under authority of LC. 36~7 et seq, General Assembly of the State of Indiana, and aU 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
use or occupied until a Certificate of Occupancy has been issued by the Department of Community Se~ices, Carmel, Indiana. I
LI of/f.fIJA/DtJ flzIJS/-//J.j;J 7-J-{) 7
Print
Date
OFFICEUSEONLY:********************************************1*~*~**~f*****************
Filing Fees: ':2 .(c/'....)(J
SPEC110NS REQUIRED: - 'J P /] :-7J '
Base Inspections: \'Y U /. ..) (j # Charged Re-
.~<"< ,/:0 Rev,lews
Cert. of Occupancy: J u' 2-!
S ~ 7. ~O
TOTAL: . /rf' '? )-cJ
Additional Fees
~.
P.RJ.F.:
Reviewed/Approved: Dep. of Community Services (Date)
S:PermitsjFormS/ILP RESIDENTIAL
Fee Received by: