HomeMy WebLinkAbout14050191 Application � �
`��y�� CITY OF CARMEL / CLAY TOWNSHIP PERMIT # 1�I OSOI`I{
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� �� RESIDENTIAL IMPROVEMENT��LOCATION PERMIT APPLICATION Sewer / Water Utility
inoux� � For New Structures,Additions,Remodels;and Accessory Structures Permit$� 0 0
BUILDER NA PNONE FAX
oF �i� �Y: s �i !-142��'�3 Zs6� 29`�'r
RECORD �REETADDRE55 p� fi� CIfY STATE LZIP �
�' {' l.� . �'�� ✓1. CJ. V'fi t�� I!J `lTt'�i
E-MAIL ADDRESS BEST MEfMOD OF
MI . �b CO ��� • �,,,,� CONTAR ,�i�yt/�L
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PLUMBING NAME o SfATE OF INDIANA PLUMBlNG CODE
CONTRACTOR � f C�/�1%� LICENSE NUMBER O [RC O UPC
PROPERTY NAME � � �r' � Fnx
OWNER � � U
STREEf ADDRE55 CITY ATE ZIP
14
� PROJEC'f LOT NUMBER SUBDI ION NAME SECfION
LOCATION � Z�I L ( g
STREET ADDRE ITY TE �ZIP
2��' �SS{� � By �1 �a
TAXMAi PARCOELNUMBOE� 1� UIZ. �OC7 20N1NG ^ FLOODZONE/5
1 Vv \/ C'f/nl1Cl�i
/V `��t1✓`��
LOTSPLR SEM(ERUT�I\LITY WAT�� SEWER/WATER
O YES O NO ��i�VV �L�nES E%CAVATOR 1 �Z\�.Q�
ll T�, v^'
TYPE OF Ty OFCONSTRUCTION MA PERMIT FLOORPUlfl
PERMIT SWGIE FAM[LY 0 TNO PAMILY 4 70WNHOME YES � NO �.S
�OFIMPROVEMENT EARLY HELEASE
EVJ S7RUCfURE � REMODEL O ATTACJIED GARAGE O ACCFSSORY BUILDING
DDIl10N-O Room/s O Porch 0 Deck Q BASEMEN7 FINISH O DEI"ACHED WRAGE 4 DEMOLCf10N ❑ YES � NO
PROJECT P�N COMMISSION/BZA/BPW DOCNEf NUMBER/5 AND/OR ESTIMATED LOST SQUARE FOOTAGE
TACDATE/S OFCONSTRUCfION, � 6O OOO �'�
� EXCLUD[NG LAND �
PDFPLANS 7YPEOFFOUNDATI�/� MANUFACTURED SUMPPUMP VORCH
C) CD � E-MAIL � SlAB 2}�$ASEMENT-Q WALK-OUT TRUSSES
O CRAWlSPACE Q POST&BEAM O POST&PIER O YES �NO f�VES �I NO �OYES O NO
STATE OF CDR NUMBER RELEASE DATE CONSTRUCTION TYPE OCCUPANCY CLA55
INDIANA ��
CDR SCOPE OF RELEASE (`(��S `a`\��g iYPE OF RELEASE
FOR70WNHOMES 0 FDN Q STR � ARCH Q ELEC O MEGi F3-5 6'R�e� OTHER
�. � �omP��a ° o�a\�° �
Y
For Singlc Family and'!wo Pamily Dwellings this permit is v�i un10�+�� � Q���i �thin 180 days o(the datc of iswancc of this permit and
mus[be comple[ed,h the Cert6caM nfOccuPancy issued,,,JJJ���''' t��(yj�{,�,.eb�t �e�e�da[c of issuance. Class 1 SWCYUre Permits are sub�ect to ffie State
of Indiana General dmirti treliv ules GAR 6751AC 12)p�q�������ames for beginning and completing construc[ion.
I�the undersisne ,agree t af y tonsVU tion�rcmnsvu��Y a n Cn,ur al[era[ion of a structure�or any change in the use ofland or
structures reyu ted by thi plication 11 comply with o orm to all p icahte la�vs ofthe State o(Indiana and the%oning�rdinanee ofCarmel
Indiana-.1993" ' 8 an a cndmentx� doPtcd under authority of'I.C.36-7 e[sc9�Gencral A 'cmbly ofthc State of Indiana�and all Acts amcndamry
reto 1 furth certi � a[o kiKh ,bath�and Ilour drains are connec[ed to the saniGry ewen I further certi(y that�he construcYion itl n t bc
us c upi d ntil ertif oate � � ancy has becn issued by the De�me� fCommu ity Sen�' � �Carmel,Indiana. � I
� �
Signahre o!Own �IlutlrorimC Agent V'Inted Name ��a
�......................................................................................� :.............................................................................................�
REQIIIRED BASE INSPECTIONS * '• PERMIT FEES
*Additional insPections maV be reyuired. c Filing./ Review $�� Re-Revie�v
1 E�Base Inspections � '�2'7.50 �
E VJ }��ower Footing �JR-ough-In � al 63.so
�/ �/ : Cer4ofOccuPancy � Other
: IQ UPper Footing Iq Meter Base Site �67 4.0� �
� P.R.I.F.
� ❑ Underslab Z87(�_67
' TOTAL
G re�.�.a� 11'l,I�-� [„13��� € : a o� �s c
; RerieweJ/Releaed—DeparLnento(CommunityServias Dare ; ; FeeN.ceived—DepartmentofCommunityServices Ua�e
�......................:................................................... ....e �:...... .::................... ......................................................i
S:�Pmnits�FOrvu�ApplicaiionsVtesideniuNLP ADPlicetiov�2009.08 lau Updved 0&IJ/1009
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