HomeMy WebLinkAbout14070024 Application ,� �
CITY OF CARMEL / CLAY TOWNSHIP P MIT #
RESIDENTIAI IMPROVEMENT LOCATION PERMIT APPLICATION .f� Sewer / Water Utility
�xm�x� For New Svuctures,Additions,Remodels,and Accessory Structures rjl,� Permit�$������
BUILDER NAME PHONE FA7(
OF (�� I�t Nomc� 3�7- 575 - �3SU x }os 3�� . 581-7� 9
RECORD STREETADDRE55 GI7Y SfATE ZIP
I spo i�, rw�d,.:. SF . 7� 5 C�,,,.il S/v 4Ge3 �,
E-MAIL ADDRESS BEST MEfHOD OF
CONTAR
Su2e1�2 Qi�o ����e � C �,1
PLUMBING NAME STATE OF INDIANA PLUMBING CODE
CONTRACTOR �j Mp�(� LICENSE NUMBER C O SS� CJ G�OS �1RC � UPC
PROPERTY NAME PHONE FAX
OWNER „ 1 317 -57S -13J'0 31"7-S1c1 —"��4]
STREET ADDRESS CITY � STATE ZIP
I �5`�0 N. r�.r.�- ` S�. ti 53J G���+�ci �rv 4 u3�
PRO7ECT �OT NUMBER SUBDIVISION NAME SERION
LOCATION I (o L ' �J�
SfREETADDRE55 S7A7E IIP
ya�o �,5-�,. fl�, � � c N k(e�3�
° 'TAX MAP VARCEL NUMBER IANLt7G FLOOD ZONE/S
- G - q- o -o�- O�i . oo JUL 0 c��z X
LO7SPLI7 SEWERU7ILITY WATERU7IL SEWER/WATER
O YES O NO C,Q R ` � G` t UTILITIESE ATOR R'�" �"`U0� L
TYP.E OF TYPE OF CONSTRUCTION MASTER PERMIT FLOORPLAN
PERMIT �SINGLEFAMILY O TWOFAMILY O TOWNHOME � YES rd'NO �e1m #
TYPE OFIMPROVEMENT EARLY RELEASE
B�NEW STRUCTURE 0 R L O ATTACHED GARAGE � ACCESSORY BUILDING
.� ADDITION-O Room/5 0 Por[h 6,�e'6eck INISH 0 DETACHED GARAGE O DEMOLiTION � YES 0 NO
PROJECT P�N COMMISSION/BZA/BPW DOCKEf f{}IMBE ESTIMATED COST SQUARE FOOTAGE
TACDATE/S <J,(� a�. F�CONSTRUCTION, ^
C� `A�. OF �/ry LUDING UIND y L Ui OU J �7y�
PDFPLANS �TYPEOFFOUNDATION jEy � URED SUMPPUMP PORCM
❑ CD � E-MAIL � SLAB B�BASEMENT-O WALK-0� C� d� �
O CRAWLSPACE Q POST&BEAM O POSI� � `b �tfj .C� , NO �YES O NO d YES O NO
STATE OF �DR NUMBER RELEASE DATE � � Z� OCCUPANCY CLASS
INDIANA !�j / I'y ryes uiat. 0
CDR SCOPE OF RELEASE �l. R� TYPE OF RELEASE
Y
FORTOWNHOMES q FDN O STR � ARCH � ELEC q MECH q PLUM � SPKL � O . �C _ •
s
For Single Family and Two Family Dwellings this permit is valid only if construction rnmmences wi[hin 180 days of the date of iesuance ofthis Permi[and
must be completed�having the CertiPcate of OccuPancy issued,within 18 months ofihe date of issuance. Class I Structurc Yertvits are subject to the State
of lndiana General Administrative Rules(GAR 675 IAC 12)regarding expiration time frameslor bcginnin�.and completing construction.
1,the undersigned,a�rce that any construction�rceonstructioq enlargemenq rdocation�or alteretion oLa svuc[u�e,or any change in the use ofland or
struRUres re9uested by this applica[ion will comply wit6 and ebnform�to ali a�plieable laws ofthe State oflndiana and tfie"Loning b�dinanee ofCarmel
Indiana-1993^(Z-289�and amendments�adoPted under authority of LC.36-7 ut sey�Gencral Assembly o![he State o(Indiana,and all Acts amendatory
therc[o. I fvrther certify[ha[only kimhen�bath�and floor drains are connected[o the saniGry sewer. 17urthcr mrtiFy that the construcHon will not bc
used or oeeuPied until a Certifinte of OceuPaney has been inued by the DePartment of Community Selrvicee�Carmel,Indiana.
�M� �t.2¢.�L S(�1n�.4�it _ ' ?��`'�
9gnalvreb�AUtho�ued Agent Printetl Name Date
�......................................................................................� :.............................................................................................�.
REQLIIRED BASE INSPECTIONS * '• PERMIT FEES
*Additio�al inspec[ions may bc required. E Filin� /Review i�..�`-!-�5CZ Re-Revicw
: Base Inspections
�� Lower Footing ugh-In inal l..rl
� ' Cert.of Occupancy �L� Other
pper Footing eter Base Si �
� P.R.I.F.
� ❑ iIndersla �Q Q�K
� TOTAL � ✓
; ReviewedLRelea.sed-D'ePartmrntolCi�mmuni[yServices� Uare- ; ; Feel eived-DepatmentofCommunityServicev /�Tr�-Date
�......................................................................................: �...... ...............................................................�.................i
S:Neoni��POVmsWppGCationslResidrntialVLP AppliwtioM2009-09 Last Upda�ed OSI132009