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City of Carmel/Clay Township
Permit#: 07100
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME: ? /// PHONE: FAX:
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RECORD: STREET ADDRESS: 3=/z2. CITY: STATE: ZIP:
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METHOD OF CONTACT:
BEST
BUILDER'S EMAIL ADDRESS:
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PROPERTY NA'E' PHONE: FAX:
OWNER
:
STREET ADDRESS: CITY: STATE: ZIP:
LOCATION LOT W: SUBDIVISION NAME: SECTION'
5ADD%b??k GJ StiG?6ov??/c ZONING:
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PROJECT
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INFO: ADDRESS OF CONSTRUCTION:
3116 l'11 , D l?, • SQUARE
FOOTAGE:
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PWATER UTILITY
SEWER
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OVIDER ESTIMATED COST OF CONSTRUCTION:
O GO
(EXCLUDING LAND VALUE)
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PROVIDER:
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NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / SZA / BPW DOCKET ^ I -stew,
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT :'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
AX MAP PARO f 7 t1 2
O C I 9 2O
ff L
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FOR THIS PROPER TT':
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170 ?1 ".706A
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TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTR R:
SINGLE FAMILY
O TOWNHOME
O TWO FAMILY
# of units being
constructed at this
time:
0 RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit: Y??
Lot Split: _Y _N
PC / C-0 ee3Z
Plumber's Indiana State License #:
Ala,.,: Ca:1,1 ;21VA&4(,
Which plumbing codes will be applied to the construction:
0 International Residential Code w/Indiana Amendments
0 Uniform Plumbing Code w/Indiana Amendments
/ FOUNDATION TYPE: (Check all that apply for the new
construction area)
? CRAWLSPACE O POST & _ BEAM -PIER
? SLAB ),?( BASEMENT (WALKOUT: Y_N )
XNEW STRUCTURE
O ROOM ADDITION(S)
O PORCH ADDITION(S)
O DECKADDITION(S)
O REMODEL
_ Basement Finish only
'? ACCESSORY BUILDING
DETACHED GARAGE
? ATTACHED GARAGE
? DEMOLITION
Manufactured
Trusses:
Sump Pump:
;l N
_N
For Single Family and Two Family dwellings, additions, remodels, and/or accessorystructures, this permit is valid only if construction commences within ISO
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months the issuance date. Class I
structure permits are: subject to the General Administrative Rules of the State of Indiana (See 675 LAC 12 a frames for beginning and
completing cons ti
1, the undersigned, agree that any construction, reconstruction, enlargemer t, relocatio the use of land or structures
requested by this application. will comply with, and conform to, all applicable laws oft! the "caning Ordinance of Carmel ladiana - 1993- (2-
299) and amendments,adopted under authoriry of I.C. 36.7 et sec[, General Assembly o. a at a of Indiana, and all Acts amendatory thereto. 1 further certify that only
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 Cerrificare of
Our `panyylfb?een i ed by the Department of Community Services, Carmel, Indiana
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Agent
Date
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OFFICE USE ONLY:
,INSPECTIONS REQUIRED: Filing Fees: !J oZ U
Base Inspections: N? # Charged Re-
_ Reviews
Cert. of Occupancy: S '
P.R.I.F.: / a (/. a Additional Fees
Fee Received
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