HomeMy WebLinkAbout14050117 Application c��v°`caq
CITY OF CARMEL / CLAY TOWNSHIP PERMIT # S
�a� r,,
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION Sewer /`Wa� r Util�ty
�reo��p�, ".� ForNew Structures„Additions,Remodels,and��Accessor.y Structures Permit$� `�W
' BUIL`DER NAME � PHONE; FAX
°OF P�. I-1e I-1uMey 3�7-575 - ��ox,os 3��-581 -» 9.1
RECORD STREET'ADDRE55 CITY, STA7E ZIP
�v N. i`��. a.. �,, s+. �-53� c<<�� tN ubu3
E-MAI�ADDRESS BEST METHOD OF
SU e�?te. ��"�v�{L�0 ..tk>. G!✓h CONTAR �mr.�. �
PLUMBING ��NAME `^ � STATE.OFINDIANA PLUMBINGCODE
CONTRACTOR �T I_ `OU f Qi LICENSETlUMBER C G,g I GvS�(� C�7/fRC O UPC
PROPERTY NAME PHONE FAX
OWNER P���-c. ��rno 3� 7-S�S• � 3� x�°S 3� 7- I-77q)
SfREE7;ADDRE55 CI7Y S7A7E ZIP
I\ ��U N, i�l.�r , �,.�. S� . fi1 s 3b �",,,� �!u `f 6v3�
PROJECT LOT NUMBER SUBDIVISION NAME SECTION
LUCATION I L il � �S��k-S 3�
STREET ADDRE55 . CITY 5TATE ZIP
� 3 L,S� n tJ�,,, C�rm�l �rV �b�
TAX�MAPPARCELNUMBER ZONING FLOOD ZONE/5
17- 0�1- 1°I -.00 - �7- O�`6�0 0 U S-I ?�
LOTSPLIT SEWERUTILIfY WATER�UTILIfY SEWER/WATER
� YES O NO C�a UTILITIESEXCAVATOR v�
Kle �na� Caome�� RT / UoI¢,
TYPE OF TYPEAFCONSTRUCRON MAS7ERPERMI7 FLOORPLAN
PERMIT �SINGLEFAMILY � NJOFAMILY � TOWNHOME � YES CkYNO ��i,,,���
TYPE�,OFIMPROVEMENT EARLY RELEASE
,P3�NEW STRUCTURE' � REMODEL � ATTACHED GARAGE � ACCESSORY BUILDING
�,q ADDITiON��—O Room/s �Porch. 0 Deck ��IB!BASEMENT FINiSH � DETACHED GARAGE� � DEMOLITION p YES ft3'NO
PRO�ECT �P�N COMMISSION'/BZA/BPW DOCKEf,NUMeER/S AND/OR ESTIMATED W5T SQUARE FOOTAGE
7ACDATE/5 �(��UD NG NDN �$ y�� � �� �S�
PDFPLANS� 7YPEOFFOUNDATION MANUFARURED SUMFPUMP PORCM
❑ CD � E-MA[L � �SLAB Q�BASEMENT—O.WALK-OUT TRUSSES
� � O CRAWLSPACE � POST&'BEAM' � D�POST&PIER @`YES �. NO 'PTYES 0 NO �YES O NO
STAFE�OF . WRNUMBER �RELEASEDATE I� STRURION7YPE OCCUPANCYCLASS
INDIANA \�N �s � � I ��I �
CDR �XOPE OF RELEASE (�S� �\ a�5 � PEAF RELEASE
FORTOWNHOMES ❑ FDN 0 �QRY \�'EIEC ❑ CH q PWM � S LR � T ER
F, Ua°�e a�`�0- � �Q '
For Singlc Pamily - �,d����1' b s f�j valid�onl'y'if mn' Fuction comivences�wit6in.180 days f tFe date of issuance of ffiis perroit and
must be completed haS�ng th ��ancy issued;with�n IB �Ijt s ofthe date oCissuance. Class I Structure Permits are su6ject to the State
of Ind�ana General Admini - �(�G��qqIAC 12)regarding exp ratwn e ' n mpleting construction.
l�the undersigned ag ���� '��y\NGConstruc[ion�enlargement�relocahon�or alteration of a structure�or any chavge in the use ofland or
struRUres requested b�(i s\�''j[4�,' tioq coroply with and conform�to alI applicable laws ofthe State of Indiana and ffie"7.oning brdinanee of Carmel
Indiana—1993"�(Z-28�.�aTnendments,adopted under authority.oFLC.36 7 et sey�General Assembly of[he State of Indiana�and al1 Acts amendamry �
thereto.J�(orthei certi�that only kitchen�6a[h�and flooedrains are connected to the sanitary.sewe�. I further certify tfiat the constru�tion will not be
used r occupied mtil'a CertiEpte ofOccuPancy has b�ecn issued by the�Department of Community Servicea{Carmel,Indiana.
L�,��• ,d���l 5�3.�-Ft-c �S���� 5 ��Il'�
5igna�ner ar AuNOAZetl Agent Printed Name Data
�......................................................................................� ;.............................................................................................�
REQiIIRED BASE INSPECTIONS * � PERIVIIT FEES
*Additional insPections may be re9uired. c Filin� /Review � - •O . Re-Review
J/ � c BaseInspections ��
i l 4 werFooting ugh-In L+7 F' al 1 7. r_�.�
t Cert.of Occupancy ��L!�!.] Other
: �pecFooting . MeterBase _ Si[e
� P:R.I:F. ._�. l�9szb
'• ❑ Underslab TOTAL �.I �P��..��
E • . ;
: . ��.�� s��y :
: �',na..; .n , , � `-( :
; Reviewed/Nele ed—Departrnen[of Community Sernces �Da[e F e�leceived Ue ent f C inmunty Sernces � ate ;
e................................................................... ..... ...........r ......G:L................:..: -.....:.........................................................�
j5:lPermhs�FOrmsWpPLcations\ResWentuM.P Applica�ion�2009-OB Last Upda�N OA/132009