HomeMy WebLinkAbout14050114 Application (2) / �<"""`°"'�� CITY OF CARMEL / CLAY TOWNSHIP PERMIT# I`(05�I1 y
� ' RESIDENTIAL�IMPROVEMENT LOCATION PERMIT APPLICATION Sewer / Water Utility
. �xoux� For New Structures,Additions,Remodefs,and Accessory Structures Permit �$ ,
BUILDER NAME PHONE FAl(
OF i-u� �ur�`c, S�'�c.Y, 3�'1 u oc,c�\0
RECORD STREET A DRESS STATE 2IP
� �, t� o k� -t2�� Qa�Lr�. �1��3�
E-MAIL ADDRE55 BEST MtTHO/�D�O�F !1
{!M\F.� IN�� -� `�c.S�-�.1��.�..� �LN� CONTACf \.'C.l.�. 1'�^'l. �11 �{� �I
PLUMBING NAME STATE OF INDIANA PLUMBING CODE
CONTRACTOR LICENSE NUMBER [� IRC C� UPC
PROPERTY NAME PMONE FAX
OWNER 2 O�-P<v �a� 5S
SfREEfADDRE55 CITY STATE ZIP
�sc��t �cz.c.�-�s�4.Q- Pi� � t�1
PROJECT �OTNUMBER SUBDMSION'NAME SECTION
LOCATION UU� �C.'C Oa�-
STREEf DDRE55 . CI'fY STA7E ZIP
SUl' ���-C��`�LS �
TA%MAP PARCEL NUMBER ZONING FLOOD 20NE/S
I �n- `'I l)-UO-UO - GB- (eo:Ga0 (Z- ,�- v a st-u�.t�.P.
LOTSPLIT SEWERUTILI7Y WATERUTILIfM SEWER/WATER
O YE$ 4 NO UTILIIIESE%CAVATOR
TYPE OF �T�/ E OF CONSfRUCfION MASiER PERMIT FLOORPLAN
PERMIT Y4 SINGLE FAMILY � TNO FAMILY O TOWNHOME O YES O NO
TYPE OFIMPROVEMENT EARLY RELEASE
q NEVJ STRUCTURE O REMODEL L}Y�ATTACHED GARAGE q ACCESSORY Bu[LDMG
'� � ADD[TION-�Room/s �Por[h �DeCk Q BASEMENT FIN[SH O DETACHED 6ARAGE ❑ DEMOLITION O YES Q NO'
. PRO]ECT P�N COMMISSION/BZA/BPW DOCNEf NUMBER/S AND/OR ESTIMATED COST SQUARE FOOTA6E
TAC DATE/5 OF CONSTRUCTION, (� � LC
� EXCLUDINGLAND ���1�� �zUp
PDFPLANS TYPE OFFOUNDATION MANUFACTURED SUMPPUMP PORCH
q CD O E-MAIL O SLAB �:8lSEMENT-QWALK-OUT 7RUSSES
� O CRAWLSPACE Q POST&BEAM 0 POST&PIER O YES CJ NO O YES O NO O YES O NO
STATE OF �DR NUMBER RELEASE DA7E CONSTRUCTION TYPE OCCUPANCY CLA55
INDIANA
CDR �OPE OF RELEASE TYPE OF RELEASE
POR70WNHOMES O FDN Q SiR 4 ARCH O ELEC 0 MECH 4 PLUM O SPKLR O OTHER
For Singlc Family and'I'wo Family.ihvcllings this rcrmit is valid only if construRion tommences within I80 days of thc datc of issuancc o(thic rcrmit and
must be completed,having the Ccrti6cate of Ocwpancy issued,within�8 months olthe date oEissuance. Class 1 Structure Permits arc subject to the State
of Indiana Grneral Administrative Rules(GAR 675 IAC 12)regarding expira[ion timc frames Cor beginning and romPleting consVURion.
I�the undersigned,agrce that any construction�reconstruction�enlargement�reloca[ion�or alteretion ofa s[ruc[ure�or any change in the use ofland or
structures reyuested by this apPlication will comPly with and conform to all aPPlieable laws of the State of Indiana and the°%oning brdinance uf Carmel
Indiana-1993"(Z289)and amendments,adopted undcr authority of LC.36-7 ct sey�CenerafAssembly of thc Statc of Indiana�and a0 Atts amendatory
'16ercto. I fu� i certify[hat only kiichen�bath�and Iloor drains arc connttrted to the sanitary sewer. I further certify that lhe construction will not be
�uS ��cu"e until a Certifinte o(OccuPancy has been issued by the DiPartment of Community Services,Carmel,Indiana.
!.
�AK�c. 1�/�s�-E.�J'tc� S i� zoiy
5ignahre rorA mizedAgent PrintedNeme Da[a
�......................................................................................� �.............................................................................................�
REQIIIRED BASE INSPECTIONS * � � PERMIT FEES
*AdditionaLinsPections may be required. i Filing/'Review Re-Review
�// E Baselnspections i q�
� ❑ Lower Footing I� Rough-In � al (n�
�,/ : CerLOfOccuPancy Olher
: LX Upper Footing ❑ Meter Base �Site
� P.R:I.F.
' ❑ Underslab
�,�J TOTAL �__
: �,. _� /�I s�/ 5�Z7�� : ; ///a�-_--� 0r z'l I y :
; limiewed'J R e ed-DePanment tiFCommunity SerJices :Ua.e ; ; Fee li �eiJeA-Department of Cuinmvnity Services Date ;
ss
�......................... ............... ......... ....... ..r �..............................................................................................�
S1PermusWrmsWpplicationsV2esidentaNLP AOPlicetav12009-OB last Updved OSIIJ2W9