HomeMy WebLinkAbout14060010 Application o�r"�"*�', 1 ''� (
� . CITY OF CARMEL / CLAY TOWNSHIP 11 �,'\ ERMIT # 1y060�/D
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� � RESIDENT[AL IMPROVEMENT LOCATtON PERMIT APPLICATION Sewer / W+a�J*P��(T""�"
� �xoux�` �ForNew Structures,Additions,Remodels,and Accessory Struc[ures Permit �, {-1 �" � �
BUILDER na"'E PHONE FA%
oF � � ���,-� 3�� - - - � 3� - � - �io
REGORD �TREEf,ADDRE55 CITY STATE ZIP
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E-MAiL'ADD ESS /� BE EfHOD OF
��VV��j 5 . .Sl:.� �4��d/�QN� CONTAR3r �- 339-�13&'
PLUMBING NAME STATE OF INDIANA PLUMBING CODE
LICENSE NUMBER
CONrnacrOR ,,,� �,,s �. I b0�0I�I o [RC o ux
PROPERTY NAME PHONE '(�. { FAX
OWNER �G� '� 3��- Co9g-3(o2o�y (�Sd-23p- lD7Z
STREEfADDRE55 CITY SfATE ZIP
�o95S senr� c�'�- ^' � ' ,' �a/. z8(�
PROJECT LOT NUMBER SUBDIVISION NAME SECTION
LOCATION 7 �S Eee. �M�
�STREEfADDRE55 ,��^ LITY � STATE ZIP
l 5�' lu�� 4� l� ,� ., , 5 �iJ. �,Z�U
TAX MAP PARCEL NUMBER IlCJ IN6 PLOOD 20NE/5 I
1r]- 13-I -D -lrL- , � X u �z1
, LOT SPLIT / �i ER UTILI7Y WA�UTI I7Y �E � XfAVA70R �� � ��L�e�
e vES q7 NO �__ cc�-r
TYPE OF T�TE OF CONSTRUCTION�� MASTER P RMIT FLOORP/UIN'
PERMIT 4 SINGLE FAMILY �TVJO FAMILY 0 TOWN Y O NO �/
7YPEOFIMPROVEMENT / EARLY RELEASE
�NEW STRUCTURE �❑ REMODEL � ATI'ACHED GAR4GE 4 ACCESSORY BUILDING
C) ADDI710N-OROOm/s �Porch ��Deck 0 BASEMENTFWISH � DETACHEDGARAGE 4 DEMOLITION O YES � NO
PRO]ECT P�N COMMISSION/B7A/BPW DOCKE7 NUMBER/5 AND/OR ' ESTIMATED COST SQUARE FOOTAGE
TACDATE/5 . E%C UD NG NON� ��'�ea ��p' InbO�.
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PDFPLAN�S 7�YPPP���5 �OFFOUNDATION MANUFACfURED.�K71��v�{ SUMPPUMP / PORCH �
O CD L( E-MA[L o C�W�PACE �B M,I � IER TRUSSE �S � NO O YES OY NO � YES SO NO
STATE OF CDR NUMBER ELEASE DATE CON5TRURION TYPE OCCUPANCY CU155
INDIANA
CDR SCOPE OF RELE TYPE OF RELEASE
'FOR70WNHOMES 4 �FDN 0 STR ARCH 4 ELEC H 4 PLU � SPKLR O OTHER
S. 5
For Singlc Family and TH'o�F�� c,�nnB e e't is vali ��' ly iCconstru�Kim commences within 180 days o(the datc of issuance of this permi[and
must be complcYed,ha i�i�eg ,c +��.�..�e� [hin IS months of the da[e oFissuance. Class 1 S[ruclurc Permits are subject lo the SUte
of Indiana CcneraPAdmiril8 ve�b ��`�U�p expiratlnn time Games Cor beginning and completing mns[ruction.
I�the undersigned,agree that an � n argement,relop[ion�or a�reration ofa etructure,or any change iu thc usc of land ur
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svuctures rcyuesMd by[F�a �tSA c t�i�and conform to all�applicable laws of lhe SGte oflndiana and the°Zoning Ordinanee of Carmel.
Indiana-1993 ('J 289)an � [��der aut6ority of I.C:36-7 et se�,Gencraf Assembly of Ihc Statc of Indiana,and all Ac[s amendatory
thereto. I further cer[i�C���y che� �U71N Ooor draini are connec�ed[o thc sanitary sewer. I(urther certi(y that the construaion will not be
d ied until ilieate of Occ panry has becn issued by the De artment nf Commum Services� artnel Indiana.
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nature erorA rittdHgent VrinFetlNeme e�- Date
�......................................................................................� ,.................:............................................................................�,
REQUIRED:BASE INSPECTIONS * � FERMIT FEES �%�, ^N'�
*Additional.inspections may be requircd. : Filin�/Review � Ro-Revie�v
,..,(/ �C!, E Base[nspections --)a 1� �,�
i � � tower Footing YJ Rough-In LJ 'nal ,j� ,2 �/1
/ � c CerL of Occupancy �iuv Other
�UpPer Footing �'Meter Base 1� Site � � _`�(} �'�O
/ ; P.R.LF. }�a.�=Q
� Q Underslab TOTAL ��a• I /
� Review-ed/Released- eparnn t of Communi[)'Senices a r� � ; Fee Received-Departmen[of Commwity Service.r Da¢ �
i........................�.�........................................... ................i �..............................................................................................i�
�S:Wermys�FnrmsWpplica�ions\ResidemuM.P Application�2009-OB Iss�UrylavA 08/13R009,