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City of Carmel/Clay Township
Permit #: o70SD 145
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
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BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
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PROPERTY NAME: PHONE: FAX:
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STREET ADDRESS: Cm' SubjeCt to Ct`!M(, Ftf. 4FVi1TLAi! Ic)t;ulatlona
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LOCATION LOT:: ,t- SUBDIVISIO E: Q[ ON ?i J: `
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PROJECT V
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INFO: ADDRESS
Z2 L -27 OF CONSTRUCTION: uii
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Rt6TAGE:
SEWER UTILITY
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PROVIDER: CT2 WATER UTILITY
PROVIDER: ESTIMATED COST OF CONSTRUCTION: o,
(EXCLUDING LAND VALUE) 77 O 12 el Cj
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NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET O D if
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IF APPLICABLE
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NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMI a?
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL AUGC?:6,ZOO7
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FOR THIS PROPERTY:
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TYPE F CONSTRUCTION:
SINGLE FAMILY
O TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
0 RESIDENTIAL (For
Additions, Remodels, Etc)
PROJECT INFORMATION:
Early Release
Permit: _Y _N
Lot Split: _Y _N
TYPE OF IMPROVEMENT:
Gam- EW STRUCTURE
O ROOM ADDIrION(S)
O PORCH ADDITION(S)
O DECKADDITION(S)
O REMODEL
_ Basement Finish only
D ACCESSORY BUILDING
O DETACHED GARAGE
? ATTACHED GARAGE
O DEMOLITION
Manufactured
Trusses: "/Y _N
Sump Pump: c-l' N
PLUMBING CONTRACTOR:
Indiana
Which plumbing codes will be applied to the construction:
7L. -Mtemational Residential Code w/Indiana Ament
C) Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
O CRAW LSPACE O POST & _ BEAM -PIER
l AB B-BASEMENT(WALKOUT:Y_Leel?
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences within 180
davs 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 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 that any coustmcton, reconstruction, enlargement, relocation, or alteration of a stricture, 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 :he 'Zoning Ordinance of Carmel Indiana -1993' (Z-
289) and amendments, adapted underautha=ty o: 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 cer tify that the construction will not be used or occupied until a Certificate of
Occvpancyhas been issued y the Department of Community Senices.CCCarmel, Indiana U v_d7
Sig of Owner dTAuMVCe 9 Print Date
OFFICE USE ONLY: a**aaaa****asaaasaariasa*******a*****saaaaaaaa**aasa? e, i:ay*********aasaaaaaa
INSPECTIONS REQUIRED: Filing Fees:
Base Inspections: Charged Re
U er ng wer otin Under Slab Reviews
Cert. of Occupancy: •?Y S0 Rough In Meter Final Site
P. R.I.F.: p'QAdditional Fees
-(/7 TOTAL:
22-
Y-ved: DepKof Community Services (Date)
RESIDENTIAL Fee Received by: Date