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IVI-; Permit #:020161
City of Carmell Clay T o*wship
- ?? -PRESIDENTIAL I1"ROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME: PHONE: FAX:
RECORD' STREET ADDRESS: QTY: i STATE: ZIP:
Z.1 t. e,
BUILDER'S EMAIL ADDRESS:
L,> fi????, ELI gff L_tCffrC) S7FJCTI 1
PROPERTY NAME: PHONE: D} 5#a }@ G. I' 1`s,C'UE'S.
OWNER: ti
STREET ADDRESS: CITY: CITY OF CAR 'tTE/ CLAY TCVNSHIP
LOCATION
& PROJECT LOT SUBDIVISION NAME: ( f? ri SECTION: ZONING:
INFO: ADDRESS OF CONSTRUCTION: SQUARE ?
FOOTAGE:
SEWER UTILITY
PROVIDER: =' ," ' I WATER UTILITY
PR V DER: ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) y _
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA i BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):?v."`
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL
/1
FOR THIS PROPER p !
TYPE OF C014ST r W y TYPE 'S IMPROVEMENT:
SINGLE FAM
P,( ,
STRUCTURE
TOWN HOM
? TWO FAMIL
L
? RO ADDITION(S)
POR H ADDITION(S)
# units
ing ADDITION(S)
Construct REMODEL
time: _ Basement Finish only
0 RESIDENTIAL (For ? ACCESSORY BUILDING
Additions. Remodel s. Etta) DETACHED GARAGE
ATTACHED GARAGE
PROJECT INFORMAT ION: ? DEMOLITION
Early Release
' Manufactured
Permit: ?Y
N Trusses: Y JN
Lot Split: Y -- N Sump Pump: ` Y JN
PLUMBING OONTRA ? -' g IC• - /?,1$ ? .ter tft
Plumber's Indiana State License
Which plumbing codes will be applied to the construction:
Q International Residential Code w/Indiana Amendments
0 Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for
construction area)
0 CRAWLSPACE ? POST & BEAM
SLAB Q, BASEMENT (WALKoLjT:
For Single Family and Two Family dwellings, additions, remodels, andlor accessory structures, this permit is valid only if construction commences within 180
days of the date of issuance of the building permit„ and roust be completed (Certificate of Occupancy issued) within 16 months of the issuance dare. 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.
1, the undersigned. agree that my construction, reconstruction, enlargement, relocation, or alteration of a sructure, or any change in the use o land or structures
requested by :his application will comply wid, and conform to, all applicable laws of the Stare of Indiana, and the -Zoning Ordinance of Carmel Indiana - 19993" (Z-
289) and amendments pted under authority of E.C. 367 et seq, General Assembly of the State of Indiana, and all Acts amendatory :hereto. I further ces[ify that only
kitchen, bar dra_ns are connected to the sanitary sewer I further certify that the constryction will not be used or occupied until a Certificate of
ana. '
occupa aC issued by the Department of Community Services, Carmel Ind'
Sian ate r e er 6wsrer ? Au thori zed 0.o2at print Date
Filing Fees:
Base Inspections:
Cert. of Occupancy,
P.R.I.F.:
S,5_1 5_0
2?k 00
Additional
Date
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OFFICE USE ONLY: