HomeMy WebLinkAbout14030162 Application y� ��d3c�-�c��
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��""""� CITY OF CARMEL / CLAY TOWNSHIP PERMIT # ���' �
RESIDENTIAL�IMPROVHMENT�LOCATION PERMIT APPLICATION Sewer / Water Utility
�nnux�� For,New$truc[ures�Additions,Remodels,.and Accessory Structures Permit$�
BUILDER NAME PHONE FAX
oF ti.� Qes; �:.,-� A . �r� /7-yso qs�yS
RECORD �TREETADDRES� CITY STATE ZIP
Z � �,q+,ac �' ��07`�
E-MAIL ADDRESS� BEST MEfHOD OF
� .0 2 s; " ,' L�� CONTAR 3� -yso 9
PLUMBING NAME STATE OF INDIANA PLUMBING CODE
CONTRACTOR LICENSE NUMBER p IRC � UPC
PROPERTY NAME Sub S PHONE FA%
OWNER oT ' �� � �0 - 97-83y7
SfREEfADDRE55 pf � ' ll , 1, CI7Y STA7E ZID
�l9Go �i°EPr Ss ��`.:`C ��;�h"T� a3Z
LOCA ON �OTNUMBER � ' � `�fvlby�rypu 'Jl;_�1�;G%,' SERION
n? % S
SiREEf ADDRE55 n( � " .A�i �.^ . I��6I7Y STATE ���Z
/�,i� �ij
� �K
TAX MAP PARCEL NUM ER � G PLOOD 20NE/5
.3 oe
LOTSPIIf SEWERU7ILI7Y W I U ER/WATER
Q YES 0 NO , LITfES EXCAVATOR
TYPE OF TYPE OF CONSTRUCfiON �nR � M ER PERMIT FLOORPLAN
PERMIT �C SINGLE FAMILY O TNO FAM �TOWNHOME YES Q NO
TYPE OFIMPROVEMENT EARLY RELEASE
O NEW STRUCTURE l] REMODEL � AT7ACHED GARAGE O ACCESSORY BUIL�ING
Q ADDffION-O Room/5 q Porch O - -P7Y 6H f� DE7ACHED GARAGE q DEMOL[TION q YES q NO
PROIECT P�N COMMISSION/BZA/BPW DO UMBER/S AND/OR ESTIMATED COST SQUARE FOOTAGE
TAC DATE/S OF CONSTRURION,�� ��
� EXCLUDING LAND p
PDFVLANS TYPEOFFOUNDA7ION MANUFARURED SUMPPUMP PORCH
❑ CD 0 E-MAIL StAB O BASEMENT-�WALK-OUT TRUSSES
CRAWLSPACE Q POST&BEAM Q POST&PIER �[ YES O NO 4 YES � NO 4 YES �NO
STATE OP CDR NUMBER RELEASE DATE CONSTRUCfION TYPE OCCUPANCY CLA55
INDIANA
CDR SCOPE OF RELEASE TYPE OF RELEASE
FORTOWNHOMES O FDN 4 srn Q ARCH � ELEC 4 MECH O PLUM O SPKLR � OTHER
For Single Family and'Cwo Pamily Dwcllings this permit is valid unly if construc[ion commences wi[hin 180 davs o(the date of issuance of this pertnit and
must be mmpleted,having the Certiiicate o(Occu(wncy issued�wilhin I B munths of the date of i�suance. Class 1 S[ructure I'urmits are subject to the State
of Indiana CenerabAdministratire Rules(GAR 675 IAC 1?)regarding expiration time Games for 6eginning and completin�.construction.
1�the undcrsigned�agrce tha[any crostruction�rcconrtruction,enlargemenq relocation�or alteretion of a structurq or any change in the use ofland m
strunurespequested by this application will comply witfi and conform�to all applicable laws ofthe State of Indiana and the°'l,oning brdinanee o(Carmcl
Indiana-1993^(G289)and amendments,adopted undcr authority uf I.C.16-0 et seq�Gcncral Assembly ofthc Sla[c of Indiana�and all Acts amendatory
the rther certify that only kitchen,bath,and floor drains are connected.to the vniGry sew'er. 1 further eerti(y that the construction will not be
u ed or cupicd u i C�cy of O cupancy has been issued hy the Department ofCommunity Scrvices,Carmel,Indiana.
/j L ��onaLp L. /•lwG.Y �_�Y
SIg ature oF Owner or Autlrodaed Agent PdntM Nama Date
�......................................................................................� ;.............................................................................................�
REQUIRED BASE INSPECTIONS * � PERMIT FEES
*Additional insPections may be required. c Filing / Review v O� Re-Review
i Base Inspections � ���
i ❑ Lower Footin�ouph-In Final I„ 'l . -�
� : Cert.of Occupancy �� Other
UPPer Footin ❑ Me[er Base ite �•
� P.R.I.F.
nderslab , �
��� — TOTAL -
. : : � 0 -1 :
; Iteviewed�/Released—DepattmentofCommunityServices Date ; ; Fe Receivc� - e . tmen u( ommuni[yServices Uate ;
�......................:................�...............................................r ��......:.:.....::......::... .................................................................
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