HomeMy WebLinkAbout14070063 Application " �vN`�AywF!\
i SWIl�Il�IING POOL / SPA CONSTRUCTION
. For Commercial, Institutional, or Residential Projects � ���, ��
'����+' City of Carmel;Depastment of Commuaity Services PERMIT#: � �� v
BUILDER of �ME PHONE: FAX:
RECORD: - - 5
STREET ADDRESS: CIT': STATE: ZIP:
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BUILDER'S EMAIL ADDRF55: BEST METHOD OF CONTACT:
F't11 ��S (_mr�i� _ji"1 - 7ly 3r`i�
PROPERTY NAME: PHONE: FA%:
OWNER � � 3i' - �" �
INFO: �TREEf ADDRE55: QTY: STATE: IIP:
Q �, ver r Cc,� — � � �603�
PRO)ECT �DRE55OFCONSTH �
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LOCATION P' r ' � nrm� L ;L
INFO: P OJECT NAME:(If apPl I ��` � LOT�#arM SUBDMSION NAME:Qf applirable)
�e � n � 5 — ����b�G�'� ' G� r ��
ESTIMATED WST E �] RE TYPE,
OF CONSTRUClION: �j By ing deck area: `j Gj O IF APPLICABLE:
SUMP PUMP: ❑ YES � NO pOOL COLOR: IS ANY PART OF PROPERTY WITHIN
(If YES—INDICATE DRAINAGE ON SIfE PLAN) ' SPEQAI FLOOD HAZARD AREA: ❑ YES � NO
STATE COMMERCIAL CLASS OF POOL SCOPE(S)OF
DESIGN RELEASE # _�. IF COMMERCIAL� RELEASE:�' POOL COVER: ■ YE$ ❑ NO
IF APPLICABLE:
AUTO FILTER: (� YES ❑ NO SEP'iIC SYSTEM: ❑ YES � NO POOL HEATED: � YES ❑ NO
IF HEATED: L�1 GAS ❑ ELECTRIC SLIDE: ❑ YES � NO DNING BOARD: m YES ❑ NO
POOL BUILDEF2$WILL BE RGSPONSIBLE FOR: Notification[o pool owners that thesc insPections arc to be m��ic,and also will rclatc thc various c�odcs
applicable. Pool builders shall coordina[e with owners for thc inspector's access[o site on days insPections ar���'h'��i�L Under the Carmel /Clay ZoninD
Ordinance, Chapter 19.Q Sec. 29.06.08: "Late Fees sha/16e assessed on misred inspections, in 1��� y withaut a C/O".
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l�his Permit is valid only if construction commences within 180 days of the date o � C�,�iP�l�BC���"",,�mpp��t and be comPleted,having the
Cer[ificate of Occupancy issued,within IS months of the da[e of issuance. � . 1 ���e�7[�+�4,1�w�'���ate of Indiana General
�
Administrative Rules(GAR 675 IAC 12)regarding exPiretion time frames fo eb�tp4ng��.C�e� \I j��
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I,the undersigncd,agree that any conswction,roconswction,enlargement,reloation,or al �i pl4's`V` r�,bY ny�change in the use of land or structures
requesred by thie applintion will comply with and conform ro all applieable laws of the Smte�����l���i�+'dinence of Carmcl Indiana—1993"(Z-289)anA
amendmentc,adupred under authority of I.C. 36-7 et seq,Geneal Assembly of the State of n all Ac� endarory thereto. I funher certify that only Wtchen,
6ath,and Floor drains are connected ro the sanitary sewu. 1 further certify thet the conxtruc�n will not be used or occupied wtll a Certifica[e oC Occupancy hu been
issued by the Departmcnt oC Community Scrvices,Carmel.Indiana.
1 also certify,under�he penalties oE Perjury(Indiana Code 35-44-2-1)that all of the inCormation[have provided in this A�plica[ion and other
doeumencation is true and accurace to the best of my knowledge and belief,and�ha�I have not knowingly or in[en�ionally provided or omitted
anv information[hat would tend ro hide,obscure,or otherwise mislead the Dept.of Communiry Services regarding the truth oE�he macters
addressed.
A�, YY��v- �oc�ls F��J ��ri� ��ik� -��a� �f fu�l --i�
s��.��or Ro.�omo.+.d,4m� eam�arv � n.e.
OFFICE USE ONLY•tx+����x�s.�x�wv.+ewv.u:tvrx3t»xtwwrx�:�:�+kter.�e+:+e��rr+��::+��«�w+��nr+wexexe++e��:�sx««n�:�<«s.��e.e+ew�w,e:ewr,xz
PE� N -- �1
PERMIT FEE(Flat Rate +Sq. Ft. fee):
� BONDING / GROUNDING
INSPECTION FEES: ���
nd BONDING / GROUNDING /�, �
CERTIFICATE OF OCCUPANCY: IU 3 •
FINAL- Bldg _ FINAL- FORESTRY �
TOTAL: �� '
FINAL—Carmel Fire Department
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C1� Fee R e by: Date
Reviewed/App ved: Dept. of Community Servicz< ( G
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