HomeMy WebLinkAbout14070007 Application ;
��� CITY OF CARMEL / CLAY TOWNSHIP � R IT # / �I��O�°7
RESIDENTIAL'IMPROVEMEN"f LOCATION PERMITAPPLICATION Sewer / Water Utility
ixoux�. � For New Structures,Additions,Remodels,and Accessory Structures Permit�$ �y07000 6
BUILDER NAME /' PHONE FA%
OF � I��O�f� . GA N ('�fOJ 17- 1005-$7R�
RECORD STREE7 ADDRESS CI77 STATE IIP
► i32 S' R4 ���,�. (2Z. ��,w...� 2N Z
Ew-M1AIL ADD/�RESS T BEST MEfHOD OF
/�W�°Yl� O�OW�I.V2S� nl7roJ .CO� CONTAR PI.`OK�
PLUMBING NAME 1 STATE OF INDIANA Q 1 PLUMBING CODE
CONTRACTOR �(��r �I J W�7� L�-L �I�ENSE NUMBER I 1 O� I\ O Q 1RC Q(UPC
PROPERTY NAME PMONE FAX
OWNER S° � iwNa. �uloord 31�-370- 8oi5
SfREETADDRE55 CIfY� STATE ZIP
7(�K� i3�rt Sh�„�o., sa- ��:;4� �i N y z��
PRO7ECT LOT NUMBER SUBDIVISION NAME SECTION
LOCATION �Z bbltS�avti Mrwo n
STREET�ADDRESS . CITY STATE ZIP
7(o0 'rrw�ls�d.- 17���e Cunwl �/�va3Z
7A%MAPPARCELNUMBER ZONING FLOODZONE/5
I�-O�i- 25- 08-0�- 0�2. - --„- uo
LO75PLIT SEWERUTILITY WAT � � l�r `�.5 /WATER
O YES � NO qChta�I U ��I 1� - { � '.y' UI I I IES EXCAVATOR '�IGJGA'�0�1
�7C CvJr-k-j 0�
TYPE OF T�'DEOFCONSTRUCTION 1,,1 O 1 " M PERMR FLOORPLAN
PERMIT SINGLEFAMILY q TWOFAMIL Q'�oWNHOME Q ES �NO
TYPEOFIMPROVEMENT EARLY RELEASE
�NEW STRUCTURE 4 REMODEL - HED GARAGE � ACCESSORY BUILDMG
' �Q ADDIT[ON-OROOm/5 Q,POrch ��De � ❑ AGHEDGARAGE � DEMOLITION � YES�NO
PRO]ECT P�N COMMISSION/BZA/BPW DOCK MBER/5 AND/OR ESfIMATED CO5T SQUARE FOOTAGE
TACDATE/S OFCONSTRUCTION, �56y 7�O 5 3g4
� EICCLUDING�LAND / �
PDFPLANS TYPEOFFOUNDATION MANUFARURED SUMVPUMP PORCH
❑ CD O E-MAIL 4 SLAB �j{B0.5EMENT-Q WALK-OUT 7RUSSES
4 CRAWLSPACE Q POST&BEAM O� POST&PIER 4 YES 1Jj, NO �YES � NO fr(YES O NO
STATE OF �DR NUMBER RELEASE DATE CONSTRUCTION TYPE OCCUPANCY CU155
INDIANA
CDR SCOPE OF RELEASE TYPE OF RELEASE
FORTOWNHOMES O FDN O STTt � ARCH 4 ELEC � MEQ1 O PLUM 4 SPKLR O OTHER
For Single�amily and Two Family Dwellings this pertnit is valid only iCconstruRion commences within 1P0 days o(the date o(issuanee o(this permit and
musc be complered,having che Certifieate of OccuPancy issued,within 18 months of the date oCissuance. Ciass I Struclure Permib are subjcet to the State
of Indiana General Adminis[rotive Rules(GAR 675iAC�12)rcgarding expiration timc Games(ur 6cginniny.and completin�mnstruRion.
1�[he undersigned�agree[hai any cnnstruction,reconstruc[ion�enlargement,reloption,or alteretion oCa struc[ure�or any chanKe in the use o(land ur
sVUClures requcsYCd by thie application will comply with and confortu�to all applicable laws of the State of Indiana and ihe°%oning ardinance of Carmcl
Indiana-19%"(Z-289�and amendmcnta,adoPted undcr authority of 1.C.36-7 et se��General Assemb�y o(the SWte o(Indiana,and all Acts amendamry
thereto. 1(urther e v4i(y that only 1' chen�balh�and floor drains are mnnected to[he sinitary sew�er. 1 further certify tha[the construction will mt be
used or occu ' � _Qrtifi ,t oCOccu�ancy has been issued by�e Departryept of Commun' Serv�ces,Carmel,Indiana.
M �� ����- �
Signaty nwarautho d ent PAnteEName
�......................................................................................� ;.........................:...................................................................�
REQUIRED BASE INSPECTIONS * � � PERMIT FEES
*Additional inspections may be re9uircd. i Filin� / Review IOS 3 . S Re-Review
E Baselnspeclions 327.50
�ower Footing ough-In � inal y�p
c Cert.o(Occupancy Other
UpPer Footing. Meler Base � Site �8 t a0
- � P.R.I.F.
� ❑ Underslab �
ToTAL i ?'2-91�
; Re�iewed/Relessed—DeP ento(Communi[ySenicee Uare , ; FeeReceived—DepartmentofCommvnity&rvires Uatc
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