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=-`;-RL7w City of Carmel/Clay Township permit #: 0 "91
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
away For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME PHONE: FAX:
350
PUI-OF ES 575
OF -
RECORD: STREET ADDRESS: CITY:
t5_130 m 1 T :
CAS STATE ZIP:
03a-
pUL
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
EMAIL
,
PROPERTY NAME: PHONE: FAX:
OWNER:
STREET ADDRESS: CITY: STATE: ZIP:
LOCATION LOT #: SUBDIVISION NAME:
EK VILIATE
2
1 rl SECnO : ZONING:
& PROJECT U
-
INFO: ADDRESS OF CONSTRUCTION:
F SQUARE
FOOTAGE:
'
u
1
WATER UTILITY
SEWER UTIUTI'
PROVIDER: Q?(7 11 PROVIDER: / s P 1JJ M L
/ ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) I
L45
T
/ BPW DOCKET
NAME OF UTILI71' EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA
IF APPLICABLE): A
AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #S (
NUMBERS
TAC DATE(S) ,1
-
' I ?
2 ? X C
;
; ,
C6
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,
ZONE FOOR THISS PROPERTY: NATION(S) " Tr 4
- D
f CEL t:
0
1 ? P PAR00
U
O
JUV
/ -
- -
J
TYPE -'OF CONSTRUCTION:
CY SINGLE FAMILY
? TOWN HOME
D TWO FAMILY
# of units being
constructed at this
time:
? RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit: Y N
Lot Split: _Y "
TYPE OFIMPROVEMENTr_
NEW STRUCTURE
ROOM ADDITION(S)
? PORCH ADDITION(S)
? DECK ADDITION(S)
O REMODEL
Basement Finish only
? AC_CESSORY BUILDING
? DETACHED GARAGE
? ATTACHED GARAGE
D DEMOLITION
Manufactured
Trusses:
Sump Pump: I/ -
4-
Plumber's ndiana State Li a #:
0 ?I _ ? 1, AM, 2,1 ?nn,
Which plumbing codes will b applied to the construction:
&'International Reside ndiana Anne
O Uniform Plumbing Code w/Indiana
FOUNDATION TYPE: (Check all that apply for the new
construction area)
? CRAWLSPACE ? POST &?a BEAM , PIER
O SLAB W/WtSEMENT,(AJ"QLQ6T:_Y!-N)
For Single Family and Two Family dwellings, additions, remodels, and/or acces.,,._ __.uctures, this permit is s cgrr?VYton commences within ISO
days of the date of issuance of the building permit, and must be completed (Certificare of Occo? cy ih. gf the " e daginning e., Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 67 pGt>s`''y x t' s r\LdT and
completing constr-ucta ro¢. QmQ LG S NCj
1, the undersigned, agree that any construction, reconstmctior, enlargement, _elocation, or ix '£ ?j IK and or strut^res
requested by this application will comply with, _nd conform w, all applicable laws of the Sta'A ane?,: at of Carmel Indiana -1993" (Z-
283) and amendments, adopted urderauthorlry of I.C.36-7et seq, General Assemblyof the S-neof Indiact?4m o thereto I furher certify that only
ldtchen, bath, and floor drains are connected to the oamrar,'sewer. I further certify that the cons ol>f GI ?p???Se?q 1 pied until a Certificate of
Oecvpancyhas been issued by the Depar?g'ent of Community Services, Carmel, Indiana- Q
?1 M1A A LL?L'Z Gf \I zbLo [log
Si of Owner or AU Aae t Print Date'
1EF1d USE ONLY:
INSPECTIONS REQUIRED: Filing Fees: /
Base Inspections: p Charged Re-
Upper Footi ower Footing ttder.Slab Reviews
Cert. of Occupancy: S SU
ough In Meter Base Final Site
P.R.LF.; 1? ? ? GQ Additional Fees
' 90
Revlel ved/Approv Dept. of Community Services (Date)
5:Perm1t&1Fom,s/ILP RESIDOfflkL Date
Fee Received trv: