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RECORD:
City of Carmel~Clay Township Permit
RESIDENTIAL PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, AddiUons, Remodels, & Accessory Structures
PHONE FAX
BEST METHOD OF CONTACT:
PROPERTY
OWNER:
LOCAT[ON
& PRO3ECT
STREET ADDRESS
PHONE FAX
SECT[ON
ZONING:
SQUARE
I, E ,F -N .--_ _1_ :,:
<~SINGLE FAMILY
[] TOWN HOME
[] TWO FAMILY
# of units:
CZ] MULTI-FAMILY
# of Units:
C
Additions, Remodels,
p 1: - :; --'-AT~ :,:
NEW STRUCTURE
Under Slab
(Check all that apply
construction area)
[] CRAWLSPACE
Lot ~ Sump Pump: SLAB
Does any part of the property lie within a special Flood designation area: ~
didom, remod~
within 180 days of the date of issuance of the building permit, and must 1~ completed (Certfficat¢ of Occupancy issued) with~ 18 months of the
issuance dat~ Class I structure permits arc subj~c[ to the General Administrative Rules of the State o£ Indiana (Sc~ 675 IAG 12) regarding expiration
time £ramcs for beginning and completing construction.
I, the undersigned, ague that any consrvac~on, reconstruction, enlargement, re. local:ion, or ~lreration of a srrucrur~ or a~y change in rb_¢ us~ of land or
structures ~r~q?.csrcd by this application will comply with, and conforra to, all applicable laws o£ the State o£ Indiana. and :he 'Zoning Ordinance of Carmel
Indiana'1993 (Z-289) and amrmdm~nts, adopted under authority o£ LC. 36-7 er seq, Gene~ral Assembly of thc Stare of Indiana. and all Acrs am~da~ory
thereto. I further cerrif7 rhar only Idrch~n, bath, and flcor drains arc cennect~ tc ~¢ saniraty sewer. I further ce~:ffy that the construction will not b~
.~tsc~o~ occupied until a Cert~'ca£e o£Occu~cy has be~n is~a~y the Department of Community Services. Car~. el, Indiana,
3FFICE
USE
ONLY:
Filing Fees:
INSPECTIONS REQUlRED: --
InspecUons:
Reviews
of Community Sewices (Date)
Cert. of Occupancy: __~
P.R.I.F.: ~-~ ~ ~ 0 Additional Fees
./~--~ TOTAL: