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RECORD:
City of Carmel/Clay Township /~(//L)b Permit
RESIDENTIAL I/VIPROVEMENT LO ATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
~ C P~ON E .-- FAX
CITY ~ SLATE ZIP
PROPERTY
OWNER:
BUILDER'S EMAIL ADDRESS
BEST METHOD OF CONTACT:
NAME PHONE FAX
/
~ SINGLE FAMILY
~'U3'*TOWN HOME
[] TWO FAMILY
# of units:.
[] MULTI-FAMILY
# of Units:.
[] RESIDENTIAL(For
Additions, Remodels, Etc.)
TYP F M T:
~NEW STRUCTURE
[] ROOM ADDITION(S)
[] PORCH ADDTHON(S)
[] REMODEL
[] ACCESSORY BUILDING
U] DETACHED GARAGE
[] ATI'ACHED GARAGE
[] DEMOLITION
____Y ~N Hanufactured
Trusses:~-''/~ Y N
____Y~N Sump Pump: .~._Y __N
Does any Part of the PruPerb/lie within a,
For Single Family and Two Family dwellings, additions, remodels, and/or accessory
Wit hi~ 180 days of the date of issuance of the building permit,
issuance date. Class I structure
Plumber's Indiana State License #:
[] Uniform Plumbin;
(Multi-Family Construction Code)
FOUNDATION
construction area)
CRAWl_SPACE {~ POST & BEAM
N
~ 18 months of the
I, the under~gned, agree that any construction, reconstruction, enlargement, relocatioz ; use of land or
structures requested by this application will comply with, and co.om to, all ~
Indiana - 1993" (Z-289) and amendments, adopted under authority
thereto. I further certff7 that only kitchen, bath, a~d floor drains are connected to
used 0[ occupied un, til a ~e~rc~l~a£e o[~OccupaJ]cyhas been issued by the Department of Community Services, Carmel, Indiana.
OFFICE USLa~Offil¥: **********************************************************************
Filing Fees: ~