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City of Carmel/Clay Township Permit #: a7 0051
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME,
`l PHONE: FAX: y _
t?Y Y2? Y
OF
RECORD: STREET ADDRESS:
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7 CITY: STATE:
4fes
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0 ZIP:
(F6zVa
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BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
^ R O
PROPERTY NAME: PHONE: D F
OWNER
:
STREET ADDRESS:
CITI': g
A7JEP
0 7 20$7
LOCATION LOT #: SUBDIVISION NA : _ ! SECTION
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M
o 2 ZONING:
& PROJECT f
a 7
N
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INFO: ADDRESS OF CONSTRUCTION: 7 /
-f 3z W D CRL
1-e ;t ?. SQUARE
FOOTAGE:
•••"Y??
SEWER UTILITY
PROVIDER: r?
C WATER UTILITY
PROVIDER: C ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
d O 0
W wt M .
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABL
AND
TE
S `
E):
,
NUMBERS; TAG DA
(
); H
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL
C
FOR THIS PROPERTY: alf
TYPE OF CONSTRUCTION:
&-- NGLE FAMILY
O TOWN HOME
? TWO FAMILY
# of units being
constructed at this
time:
CD RESIDENTIAL (For
Additions, Remodels, Etc)
PROJECT INFORMATION:
Early Release
Permit: _Y _N
Lot Split: _Y _N
TYPE OF IMPROVEMENT:
L3EW STRUCTURE
? ROOM ADDITION(S)
O PORCH ADDITION(S)
? DECKADDITION(S)
'71 REMODEL
_ Basement Finish only
? ACCESSORY BUILDING
? DETACHED GARAGE
O ATTACHED GARAGE
O DEMOLITION
Manufactured
Trusses:
Sump Puml"t
For Single Family and Two Family dwelling
days of the date of issuance of the building
structure permits are subject to the General
PLUMBING CONTRACTOR: r"P P? is P/
Plumber's Indiana State tense #:?
/0 i ri (r q
Which plumbing codes vAll be applied to the construction:
emational Residential Code w/Indiana Amendments
D Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
D CCPAWLSPACE O POST & BEAM -PIER
?„„"_I)bLAB K,-fASEMENT(WALKOUT:_Y-!N)
valid only d' construction commences within 180
) within 18 months of the issuance date. Class I
;ardmg expiration time frames for beginning and
I, the undersigned, agree that any construction, reronstructign, enlar?ger?i ct e1o?aiioy tetapon ttV, or any chanee in the use of land or structures
requested by this application ill comply with, and conform to, all applica,ly({p?s]q ate of Ir0, Raning ordinance of Carmel Indiana -1993" (Z-
that only
289) and amendatens, adopted under authority of I.C. 36.7 et seR, General Assem rate of Indiana, and all Acts amendatory thereto. I further ce- ify
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a CertWeare of
Occupancyhas been issuedby `he Department of Community Services, Carmel, Indiana.
' ....r - <n 1 ri?ngL ge 0 C.-- - -a
11 Date
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*******************************************ss************:*,:***:*****************
OFFICE USE ONLY:
ECTIONS REQUIRED: Filing Fees: t
Base Inspections: ??CgI-r. 50 # Charged Re-
Upper Footin Lower Footi Under Slab 55.5 Reviews
Cert. of Occupancy:
Rough Meter B Final Site I
0 Additional Fees
?. P.R.I.F.: 0 I
Reviewed/Approved: Dept. of Community Services (Date)
S:Pennits/FonselllP RESIDEtITIAL