HomeMy WebLinkAbout14070070 Application _
`��y� ��� CITY OF CARMEL / CLAY TOWNSHIP PERMIT # 1Y�7 0070
.��
''" � �� RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION Sewer / Water Utility
� `�noinx>� � For New Structures,Additions;Remodels,and Accessory Structures Permit$�
BUILDER naMe _ aH E FAX
oF _ ° � �D C� (� G�7 � i• �= s'"o z �l , id3�
RECORD �RE ADDRE S CITY STATE ZIP
l 0 � �d !U � A- lr<<- wCJ /, a3 L
E-MAIL ADDRESS BEST MEfHOD OF
CONTACT
PLUMBING NAME .STATEAFINDIANA �PLUMBINGCODE
CONTRACTOR G I�/�� LICENSE NUMBER p IRC 0 UPC
PROPERTY NAME PHONE FAX
OWNER �1-b O
STRE T ADDRE55 CITY STATE XIF
� lv DLI� G CIG�.�'� L^ �<v <G Yl� 60� L
PRO]EGT L TNUMBER SUBDIVIS � � SECTION
LOCATION �� � .N c
A E55((� ' � ITY STATE 2IP
��T
TAX MAPAARCELNUMBER � ONING FLOODZONE/S
- 3 � oc>� -[� (I . �� 5 - 1 X m �hCt .
LOTSPLIT SE ER� TILITY TER:U7ILI7Y WER/WATER
o ves t5� By UTILIfiES EXCAVA70R � ����
TYPE OF TrPE OF CONSTRUCTION MASTER PERMIT FLOORPLAN
PERMIT 4 SINGLE FAMILY O TWO FAMILY O TOWNHOME � YES � NO � p � �p L
TYPEOF;MPROVEMENT
❑ NEW STRUCTURE ❑ REMODEL ❑ AT7ACHED GARAGE Y BU[L�ING
. � ADDI110N-O Roomjs O Porch O�Deck O BASEMENT FINISH O DETACHED GARAGE p DEMOLITION p YES O NO
FRO]ECT P�N COMMISSION/BZA/BPWDOCKET NUMBER/5 AND/OB ESTIMATED COST SQUARE FOOTAGE
TAC DATE/S OFCONSTRUCTION,
� EXCLUDING LAiYD
P�FPLANS TYPE OFFOUNDA7ION MANUFARURED SUMPPUMD PORCH
❑ CD O E-MAIL � SLAB 4� BASEMEN7-O WALK-OUT TRUSSES
� CRAWLSPACE O POST&BEAM O POST&PIER O' YES 0 NO O YES q NO O YES q NO
STAiE OP CDR NUMBER RELEASEDATE CONSTRUCfION TYPE OCCIIPANCY CLASS
INDIANA
CDR SCOPE OF RELEASE TYPE OF RELEASE
FORTOWNHOMES ❑ FDN � STR 0 ARCH 0 ELEC O MECH � PLUM O SPKLR ❑ OTHER
Por Single Family.and Two Family Dwelling§t6is Permit is valid only if mnstruction commences within�180 days ofthe date oCissuance ofthis permit and
must be mmpleted,having the Certificatebf Omupancy issued,within 18 monihs of ttic date oFissuance. Class I Struclure Permits are subjcet m ffie State
� of Indiana Generel Administrative Rules(GAli 675 IAC 12)regarding eicpiration time&amcs for beginning and completing rnnstru tion.
I{the mdersigned,agrce ihat any construction�rwonstruction�enlargement,relocation�or altera6on of a struc[ure�or any change in the use ofland or
. struRUres requcsted by this application will comPly with and couform�to all aPPlicatile laws bfthe State of Indiana and the"ZOning brdinance of Carmel
lndiana-1993"(Z-289)and amendments,adoPtcd under authority o(1.C.36J e[�seq,General Assembly oCthe State of Indiana�and all Acts amendatory
'thereto. 1 further certify that only kiM6en�bath�and iloor dains are connected.m ffie sanit5ry sewee I furtficr certify that the construc[ion will not be
used or occupied'.un[i1'a Certificate of Octupancy has been issued by[he DePartment of Community Service�,Carmel�Indiana.
f'A-�. l- �G� ��Y �_1_'L'_L_�
.Signa ofOwnerorAUM 'xeUAgen Prin[edName� Da[e
�...................:...................................................................� ,..............................................................................................�
REQLIIRED BASE INSPECTIONS * � PERMIT FEES
� � '.: Filing�/-Review Q•DO Re-Revie�v
Additionxl inspections may be�reyuired. ��
�i Baselnspections 6s.s� �
i ❑ Lower Footing ❑ Rough-In . ,
❑ 'Final ; Cert.of Occupancy Other
: ❑ Upper Foofing ❑ Meter Base �Site �
; P.R.I.F.
� ❑ llnderslab
�// � , ,,� ` TOTAL ZZS•So
: "//�.a✓l!V� o7/iH�►4 � �w''i�l 07 /y !
; Re wed/Released—Depar[mwtofCummunity5ervices ` )ate ; �FeeR �eived—DepartrnentofCommunity5ervices Date ;
�.......r...::._.._ _ .._ _ .., . ..........................i �................
....................:......:.................... ..............................................................................�
S:�Permrta�FOimsWpplica�ione�Re�identuM.P Application�2009-OS Lsx�Updazed Oe/lIf!009