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City of Carmel/Clay Township Permit #: ()7DWtd0
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, 8< Two Family: New Structures, Additions, Remodels, 8< Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
8< PROJECT
INFO:
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
6' SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions, Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
~~
PHONE:
" 11S-1
ow
2/0 sl/Jk
/oJ~ 1~r7e- +
BEST METHOD OF CONTACT:
6'2-:;;'
PHONE:
TYPE OF IMPROVEMENT:
~NEW STRUCTURE
o ROOM ADDmON(S)
o PORCH ADDITION(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Which plumbing codes will be applied to the construction:
o International Residential Code w IIndiana Amendments
o Uniform Plumbing Code wi Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Manufactured
Trusses:
Sump Pump:
_Y V;;
vY_N
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB erBASEMENT(WALKOUT:_Y~)
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. C ss I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames fa i I d
completing construction. ~(\~ .
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change,~~e;ll~of!liine.. \ - res
requested by thIS application will comply wit.h, and conform to, all applicable laws of the State of India~a, and the "'zonf/!. .~~~~i ~!\~naeUIn na -1.993" (Z~
289) and amendments, adopted under authonty of l.c. 36~7 et seq, General Assembly of the State of Indiana, and a ill aat"ijf~rlto. I further certlEy that only
kitche , nd floor drains re connect 0 t sanitary sewer. I further certify that the construction will b ~ccupied until a Certificate of
o rpancy n issue y artrnent f Community Service, annel, Indiana. ~
OFFICE USE ONLY: ***** ********** * **************~~****** ************1******* ***0*************** ***
INSPECTIONS REQUIRED: Filing Fees: I~ 0 7 q ()
~ Base Inspections: ~ ell
~ wer Foot~n Under Slab Sr-. s-(}
~ Cert. of Occupancy:
~ Site /) G! /10
P R I F . l~ U Additional Fees
Cfi:.AJu HL~~ .~ g-j(-q /'... ~:~/?,#,.;Jg// 00
Reviewed/Approveo: Dept. of Community Services (Date) ~
S:PermitsjFormslILP RESIDENTIAL
# Charged Re-
Reviews
Fee Received by:
Date