HomeMy WebLinkAbout14060027 Application f�✓
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`��i CITY OF CARMEL / CLAY TOWNSHIP PERMIT # I ����
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION Sewer / Water IItility
��noux� For New Structures,Additions,Remodels,and Accessory Structures Permit �$
OFILDER N���t'-� F-1.'�����LS � �- oN�'f"���� Fax
RECORD REET ADDRESS �O /y �/� ��� Cr-U' "„`(%l � �C/Z/C/
3 7-"'` c "'
L AD RESS /, / / BEST MEfHOD OP /J
G !i'J�/ ,I)' �y/j/YYj�/Ii�.,../) CONTACf � L
/ J!// 6 C%V!Gf�C.(C.� (�/ii/
PLUMBING NAME STATE OF INDI NA PLUMBING CODE
CONTRACTOR LICENSE NUMBER q IRC O UPC
PROPERTY ""�",� !� ��'�„/��r . 1�.`%/�2, �i _NE Fax
OWNER vf� Ur f�/�(1«--l�L -d/�IG�tL ,3 �f -335Z,o
57[ � � E �L � ^�. i/_ �, / STA � l �t.�/
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PROJECf LOT NUMBER SUBDIVISION NAME SECTION
LOCATION
S7gF,ET ADDRE55�` /��, j/��� . CI'fY A7 �^ZIIP�`,
L Y S�r., �i v
/
`�A1 PARCEL�NUMBE��_D , O : � .y . FLOOD ZOJJE/'����
3 ;� „
w
LO75PLI7 SE ERU7ILITY WATER�UTIL N �2 SEWER/E AVA70R
q ves o No � 'r w ��
TYPE OF TY OFCONSTRUCTION y MASTER IT FLOORPLAN
PERMIT O SINGLE FAMILY � TWO FAMILY O � YES � NO
TYPE OFIMPROVEMENT ,. � EARLY RELEASE
� � NEW STRUCTURE O REMODEL O D GARAGE 13FCCFSSORV BUILDING
� ADD[TION-�RoOm/s Q Porch O Deck Q BASEMENT FINISH Ca DETACHED GARAGE O DEMOL[TION O YES �IdO
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' PRO]ECT PaN COMMISSION/8ZA/BPW DOCKET NUMBER/S AND/OR ESTIMATED COST SQUARE FOOTAGE
TAC DATE/5 OF CONSTRUCTION, � ,ni�) /�^i/7
� EXCLUDING�UIND �l/Ci7/ � `7�f�
PDF PLANS TYPE OF FOUNDATION ���p FOR �D SUMV PUMP POHCM
❑ CD 0 E-MAIL � SLAB O BASEMENT-0 ce with a IT�I��
� CRAWLSPACE Q POST&BEAM � $�jB2lY81C�� YES � NO O YES f�SNO O YES
S'fATE OF �DR NUMBER RELEASE DA7E o a �{�ON TYPE OCCUPANCY C1A55
INDIANA D7E�/PT OF COMMUNL ��
CDR SCOPE OF RELEASE CI I I O TYPE OF RELEASE
FORTOWNHOMES O FDN O SiR O ARCH 4 ELEC O ME(71 0 PLUN,��� O OTHER
For Single Family and'fwo Family Dwellings[his Permit is valid only ifmnstruaion commences.wiffiin I80 days of the date of issuance o(Ihis permit and
must be mmPleted,having[he Certifira[e of Ociupancy issued�wiihin I B months of the date o(issuance. Class I Structure Permits are subject m the Stacc
of Indiana General Administrative Rules(GAR 675 IAC 12)regarding exPiration time fnmes for beginning and completinp constru�tion.
1,the undersigned,a�ree.that any construction,reconstrucfion�enlargement�relocation�or alteration oCa structure.or any change in the use of land or
struaure qucctcd by this aPPliwtion will cumPly with and conftirm�to all aPPlicable lawc of the State o(Indiana and thc`"l.oning brdinance ofCarmcl
India 993^(7 289 and am dmenis�adoP[cd under avthority of I:C.36-7 e[seq�Generel'Assembly oCthc State oLlndiana�and al1 Ac[s amenda[ory
[hcre[ . I furtheP crtiCy rot ��y ki �henrl�[h�and floor drains arc tonncc[ed to the sanitary sewer. 1 furthcr ceHify thal thc tonsUUCiion w'ill not 6e
�c (� ic iuntil a ificat u ancy s becn issued by the De artment of Co�nu LL Services,Carmel�Indiana. �
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gnature of Ovmer or AuMOrizod Ngent - Print¢tl Name Dale
�......................................................................................� ;.............................................................................................�
REQLIIRED BASE INSPECTIONS * � PERMIT FEES OO ,C7G
*Additional insPections may bc requi�cd. ' Filing/Review / e�� Re-Review
[ Base InsPeclionsF'�''✓ �
: ❑ Lower Footin .Rou h-In �.Final
,/J,� g g _1 [ Cert.of Occupancy _, (n3'� O[her
��p11[IPper Footing ❑ Meter Base �j,Site
�lYl / - � P.R.LF. ' ;
� ❑ Underslab .� Q
TOTAL ' �� I c
�I , . �—/U'� E �__u�.7�1� db Il /� E
; Reriewed Releaved-DeparunentofCommuNtyServices Dace , ; Feef�ece�reJ-DePar[mento(CommuniryServires Dace ;
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