HomeMy WebLinkAbout14070079 Application ; t'
, 'a CITY OF CARMEL / CLAY TOWNSHIP �'d'PERMIT # �Y470 �
� RESIDENTIAL[MPROVEMENT LOCATION PERMI'C APPLICATION Sewer / Water Utility
� ' �noux� For New'$tTUCtures�Additions,Remodels,and Accessory Strucfures Permit#
BUILDER NAME PHONE FAX
oF �r� w� �2r r 7 -�l � c5 5C'� - $45(
RECORD STREEfADDRESS � CITY SfA7E ZIP
1 N . � 2t4 ` C � � O33
� E- AIC ADDRESS BEST MEfHOD OF
Ga...�. b r �01 �e�v 5't w� ✓�f,c-�o CONTACT 3i 7—`l�3 � � CJ
PLUMBING NAME SfATE OF iNDIANA ^ ^ PLUMB[NG CODE
� %r CONTRAGTOR LICENSE NUMBER /'J /� [a �RC � UPC
I V /
� PROPERTY NAME PXONE FAX
OWNER � �t �- 317—`'ISCl—tf Z
SfREEfADDRE55 CITY STA7E IIP
I � a2Z Cr, �►2� L�r wtc� �= cND `�1 � �3z
PRO]EC'f �or MBER �1 SUBDIVLSION NAME SECf10N
LOCATION " /Q�Y ' ' � P.�D-CU�-�-LC�J✓
STR�Dfi✓ � ��V� � ` ��� L'CITY I/� (G� � �E �=cI.YJ��_
� �
TAX�MAP PARCEL NUMBER • Ul 7 O ING FLOOD ZONE/S
l� -3f- vl -o-7-ct��b c7 � 1�01¢ �
i � � _
LOTSPL SEWER^UTILITY WATERUnTILIfY SEWER/WATER
YES 4 N� GJ'�R�4'YI� CQ'(G �, B UTILITIESEX ATOR /I
/'T
TYPE OF TYPE CONSfRUCTION" M FLO RPU1N
PERMIT SINGLE FAMILV � TWO FAMILY O TOWNHOME � YES 0 NO
TYPE OFIMPROVEMENT EARLY RELEASE
� NEW STS2UCTURE REMODEL ❑ ACHED GARAGE q ACCESSOftY BUILDING
O ADDITION—�qRoom/s OPOrch O-0eck q BASEMENTFINISH DETACHEDGARAGE q DEMOLITION q YES q NO
PRO]ECT P�N COMMISSION/BZA/BPW'DOCKET NUMBER/5 AND/OR ESTIMATED COST SQUARE FOOTAGE
TAC DATE/5 OF GONSTRUCTION, ���, � �
� EXCLUDING LAND
PDfPLANS �TYVle'OFFOUNDATION MANUFACTURED SUMPVUMP PORCH
❑ CD � E-MAIL Q SLAB Q BFSEMEM—O WALK-OUi TRUSSES �
Q CRAWLSPAfF Q POST&�BEAM O PO5T&PIER . ES O NO 0 YES , NO CJ YES �tVO
STATE��OF� . ��DRNUMBER ' RELEASE'�DATE CONST(�UCTIONTYPE OCCUPANCYCLASS
INDIANA ���\�
CDR SCOPE OF RELEASE ,S J�a(�o� TYPE OF RELEASE
FOR70WNHOMES 4 FDN Q STR 0 ARCH 0 ELEC O MECH Q PLU � Ra�\L�'OTHE
�(. 0`'x��'e ,ca��� Fq.. � �
Por Single Family and'fwo Family Dwellings this permit is �p�p_r��,��9yvu �nQ within 180 days of thc date of issuance ofthis Permi[and
must tie compkted,having the Cerdfcate of Occupancy issue��nv'�thin0 of t e olissuanee. Class 1 Structure Permits are subjeR to the Sta[e
of Indiana Generel Administrative Rules(GAR 675_IAC 12)regardin �QR,Ci�i fr �for beginning and romPleting construction.
I��he undersigned,agree that any construction�reconstructio�y,�KjS�����Q�a�n�r alteretion oPa structure�or any change in the use of land or
stru�YUres rc u by this a plication will com 1 ith and c�q�fQ � 1 app e laws o(the$tacc of Indiana and the`Zoning Ordinance ofCarmel
Indiana— ^(J 9) _a endments o der authq�3�C.36-7 et scy�Gencral Asscmbly ofthc S[a[e of Indiana�and all Acts amendatory
��
there . 1 further e y t o kit n( and floor drai�are mnnected m the sinitary sewer. I further certify Ihat the construction will mt be
us or o un ' Ce C�� s becn issued by thc Dcpartment of Communily Serviccs�Carmel�Indiana.
,l70U��-�S �- �a T(� ►^J � -�o`(`
519natu o� ero Au Apen[ rin[etlName� r Oate
�......................................................................................� ;.............................................................................................;
REQUIRED BASE INSPECTIONS ��FERMITFEES
*Additional insp tions may be reyuir i Filing /Review � Re-Revie�v
c 6ase.Inspections .13� , CO
i ❑ Lower Footing Rough-In Final �
. . c Cert.of Ocwpancy Other
: ❑� Upper Foo[ing ❑ Meter Base ❑ Site
' P.R.LF.
� ❑ Underslab �
, TOTAL
; Review�ed/aR'etlezseh—DeParun�o�m[ySenices....�.IlbII�•i � FeR�eired—Departmen[o(CommunimServims O'/6 Ua[e ;
i.............. ... ..... ......... .........i.r:,i....................................:......:..................................................�
S:Wermu9FOrms\APPlica�inns�tesiden[uIVLP Applicution�2009.08 . last Updaeed Ofl1U2009
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