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City Of Carmel /Clay Township Permit #: ?-
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME'
j? PHONE: FAX.
-
' s
OF r d o C" - U d
RECORD: STREET ADDRESS: CITY: STATE: ZIP:
BUILDER'S EMAIL ADDRESS: BEST M OD OF CONTACT:
Gl .
PROPERTY NAME: PHONE: ; 5
OWNER: ?? ?
STREET ADDRESS: CITY: i u STATE: ZIP:
I
1
' Z
LOCATION LOT*: SUBDIVISION NAME: By SECTION Z ING:
& PROJECT
INFO'
ADDRESS OF CONSTRUCTION: _
)ationS
FOOTAGE:
6/ Ll Y
SEWER UTILITY WATER UTILIT
PROVIDER: PROVIDER: Y
" (E)(CL DI F{)QRUCTION: _
00
y2
/
r?r
PK ? J U G
.
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BPW DOCKET A
ANDIOR COUNTY WELL AND/OR SEPTIC PERMIT F'S (IF APPLICABLEJiUi1?i?l
NUMBERS
TAC DATE(S)
;
;
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY: TAX MAP PARCEL 9:
TYPE F CONSTRUCTION:
INGLE FAMILY
O TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
ED RESIDENTIAL (For
Additions, Remodels. Etc.)
Early Release
Permit:
OIEW STRUCTURE
O ROOM ADDITION(S)
O PORCH ADDITION(S)
O DECK ADDITION(S)
O REMODEL
_ Basement Finish only
O ACCESSORY BUILDING
O DETACHED GARAGE
O ATTACHED GARAGE
D DEMOLITION
Manufactured
Trusses: Y _N
Sump Pump: -Y _N
PLUMBING CONTRACTOR: 92g ?''le
' i's
Piumbe ndiana State License
Which plumbing codes will be applied to the construction:
Q--Erltemational Residential Code w/Indiana Amendments
? Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
O'CRAWLSPACE O POST &_ BEAM -PIER
CT-SLAB ET"BASEMENT (WALKOUT:
Lot Split:
Y
_Y _N
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. 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 construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by tills application will comply with, and conform to, all applicable laws of the State of Indiana, and the -Zoning Ordinance of Carmel Indiana -1993" (Z-
289) and amendments, adopted under authority of I.C. 36.7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto- 1 further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. 1 further certify that the construction will not be used or occupied until a Certificate of
Occupwcyhas been issu?partment of Community Services. C Indiana. //
Sionature of Owner or Authorized cent. Prii t Date
OFFICE USE ONLY:
Filing Fees: -s V
v
-?
INSPECTION QUIRED: O
??
O
50 # Charged Re-
Base Inspections: O ` ,
Upper Footing ower F g Under Slab Reviews
Cert. of Occupancy: -55, 5D
Rough Me er B Final Site
P.R.I.F.: /
LJ
Additional Fees
TOT CIA
:zu
17
Reviewed/Approved: Dept. of Community Services (Date)
S:Perff%WForms/ILP RESIDENTIAL rm 0-h-1 by Date