HomeMy WebLinkAbout14050081 Application `���� CITY OF CARMEL / CLAY TOWNSHIP PERMIT # I �J('SD$�
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!i RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION Sewer / Water Utility
�nm�x'. � For New$tructures�Additions�Remodels,and Accessory S[ructures Permit#
BUILDER NAME PHONE PAX
OF /�1Il1 �vao0 pT 8 — �Z
RECORD STREE7ADDRE55 CI7Y� � STATE IIV
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EMAIL ADDRE55 BES7�ME7HOD OF
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PLUMBING NAME STATEOFINDIANA PLUMBINGCODE
CONTRAGTOR T wQ� LICENSE NUMBER [J ]RC Q UPC
PROPERTY NAME PHONE FAJ(
OWNER s� R SG
STREETADDRE55 CITY STATE ZIV
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PRO7ECT LOT UMBER SUBDIVISION NAME , SE ION
LOCATION
STREEfADDRE55 � . CITY S7A7E ZIP
wl c a32
7AX APPARCELNUMBER ZONI FLOODZONE/5
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LOT SCLlf SEWER UTiLI7Y WATER UTILiTY SEWER/ ATER
0 YES O NO C�r� U7ILITIES EXCAYA70R C/ �
TYPE OF TYPE OF CONSTRUCfION MASTER PERMIT FLOOR LAN
PERMIT SINGLE FAMILY 4 T�^��FAMIIV O TOWNHOME CJ YES O NO
�TYPE OF IMPROVEMENT EARLY RELEASE
C� NEVJ STRUCTURE � REMODEL � ATTACHED GARAGE q ACCESSORY BUILDMG
B'�ADDITION—O Room/s O Porch �Deck 0 BASEMENT FINISH q DETACHED GARAGE O DEMOLiTION O YES O NO
PROJECT P�N COMMISSION/BZA/BPW D�KE7 NUMBER/5 AND/OR ESTIMATED COST SQUARE FOOTAGE
TAC DATE/5 (� OF CONSTRUCTION, � r oOU
< G lF � F%CLUDING�.LAND � �� �
PDFPLANS TYPEOFFOUNDATIOJf) �C�, MANUFACfURED SUMPVUMP PORCH
❑ CD � E-MAIL � SL48 L� —C�fl 1�JUT TRUSSES /
CRAWtSPACE Q . h4f �'p , Sf&PIER 0 YES Q/IVO O YES 0 NO Q YES 0 ND
STATEOF �DRNUMBER fIEL P d CONSTRUCIIONTYPE OCCU7A nn
INDIANA �'9 � d�''PP �O fRsuefF � � � V �
CDR SCOPE OF RELEASE F G O�,d � ��p TYPE OF E
FORTOWNMOMES 4 FDN 0 57}2 O ARCH �Q�d NY SPKLR O OTHER
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For Singlc Family and Two Family Dwellings this Permi[is v ' const5ru io ' �' a's of�he dat of issuance of[his Pcrmi[and
must Ae enmPleted,having the Certificate ofOccupancy issu mont ss c r �
of Indiana General Administrativc Rules(GAR 6751AC 12)regar -ef�rdtion time framcs or egi ni g ' o strucM1On.
I�the undersigned,agree Ihat any construction,reconstruction,e menq reloration�or alteration of a structure,or any ge in the use o(land or
struclures reyucsted by this aPPliution will comPly with and conform[o all aPPiica6lc laws ofthe$UM uClndiana and the°Zoning�rdinance of Cartucl
indiana-1993^(Z289)and amendments,adoP[ed undcr au[hori[y o(I.C.36-7 et sey�General Assembly ofthe Sta[e of Indiana�and all Aas amenda[ory
.thereto. 1(urther certi(y that only kitchen,bath�and iluor drains are connected[o the sanitary sewen 1 further certify that the cunstruction will not be
used oro,cc/u7 ied til a�C/e'rtqifip f Occupancy has becn issued by the Department ofCommunity Services,Carmcl,Indiana.
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Signa�reofOwneror orized 9enf PriM¢A�lame
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REQLIIRED BASE INSPECTIONS * � PERMIT FEES
*Additional inspections may be required. i Filing / Revicw ��� Re-Rcview
E Base Inspections ' ��. �� �
c ❑ Lower Footing �ough-In �Final 3 50
: Cert.ofOccupancy � Other
c ❑ UPPer Footing ❑ Meter Basc ❑ Site �—
' P.R.I.F.
� ❑ Un rslab : ��� �(n
� : TOTAL ��b �,T
�LY : '�n „� �a�A.�.11� 5 ��.� � �./� :
; Re�ieweJ/Rdeased—Departmento(CommunitySercires [e ; ; Fe liemiv —. art tu Communih-Servims a[
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S:�PeemusVarm�Applica�'ansViaidentuM.P Apptiee�ionU009-OB las�Updaud 0&132009