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�""�� CITY OF CARIVLEL / CLAY TOWNSHIP PERMIT # 7�
� RESIDENTIALIMPROVEMENTLOCATIONPHRMITAPPLICATION Sewer / WaterUtility �
M�uxp For New�$tructures�Additions�Remodels�andAccessoryStructures Permit�$
BUILDER NAME PHONE FAX
OF V�Eo(��wo�;a U.iwdY+4 Co.ne�.rY �.3��� I.lori-1a315 l.lo`t 'in;io�
RECORD $TREEf ADDRE55 CIfY 5TATE ZIP
�Z `ST STV-6E'( NCz C4ZMEl. =/J �'IIeO.:a�
E-MAIL ADDRESS BEST MEfH00 OF
CONTAR £-MA��-
1�ow E�.1�d w e ob=�woou a V,coM
PLUMBING NAME STATE OFQNDIANA P�UMBING CODE
CONTRACTOR LICENSE NUMBER
` . �. MEC1a0N3C.A1� SP02o7i(o�nS ly;[ac 4 uac
PROPERTY NAME t, PHONE FAX
OWNER S/�MF 4s o.pwE
STREET ADDRESS CI7Y STATE ZIP
PROJEG'f �OT NUMBER SUBDIVISION NAME SECTION
LOCATION 1 lo s��ACSE oF �.+ ES-r c�aY qvoU
STREEf ADDRE55 . CITY S7ATE ZIP
1323Z Fcioo.-�oa-E S;�ECC CAamEL- 2� 4��3Z
TAX MAP PARCEL NUMBER N FLOOD ZONE/S
�l'� ��I - ZQ. � OG ^ S I � X '- V NS�a NPEO
LOTSPLI7 SEWERUTILIfY WATER SEWE 7ER
O YES � NO UTIL EXCAVATOR
G�A`( CQ �--� LJNAYL CbNb1G��f�T7.UtiI
TYPE OF TrPE OF CONSTRUCTION MASTER P RMIT FLOORPUIN
PERMIT $ SINGLE FAMILY CJ TWO FAMILY 4 TOWNHOME 0 YE � NO
TYPE OFIMPROVEMENT y EARLY RELEASE
$ NEW STRUCTURE D GARAGE q ACCESSORY BUILDING
Q ADDiT10N-O Roam/s �Porrh O Deck O BASEMENT FINISH� � DETACHED GARAGE � DEMOLITION p YES hc NO
PRO]ECT T CDA7E/SISSION�RE��AJED�Vf��I�V�JTRUUIIVNR OFrCONSTRUCTION, � SQUAREFOOTAGE
� E%CLUDING LAND � 5 33�5 bC.� g ���
�F p
PDFPLANS TVPEOFFOUNDATION � MANUFARURED SUMPPUMP PORCH
❑ CD O E-MAII 4 SLAB �E/��p�y���HM�M�pliP1�I�R�ICES TRUSSES� • / _/
Q CRAWtSPACE VES � NO X9-YES O NO R)�res 4 rvo
STATEOF CDRNUMBER CIII OFL7Tf\iYILLT�CLAYTOWNSHIP CONSTRURIONTYPE OCCUPANCYCLASS
INDIANA
CDR SCOPE OF RELEASE TYPE OF RELEASE
FORTOWNHOMES Q FDN Ca STR � ARCH 0 ELEC Q MECH � PLUM Q SPKLR Q OTHER
For Single Family and Two Family U.rcllings this permit is valid only ifwnstruc[ion commences wichin 180 days of[he date n(issuance of this permit and
must 6e mm�leted{6aving the Certificate ofOccuPancy issued,within IS monthsbfthe dale of issuance. Class I Stru�ture Permits are su6ject m[he State
oClndiana General Administrafive ftWes(GAR 675 IAC 12)regarding expirAtion.time Games for 6eginnins and comple�in6 construc[ion.
I�the.undersigned�agree thatany construction�reconstruction�enlargemenq relocation,onalteretion of a stru<YUre�or any change in the use ofland or
structures requested b�y this application will cumply with and conform�m all applicable laws ofthe State of Indiaxu�and the°'Loning brdinanee of Carmel
Indiana-1993^�(Z-269�and amendments�adoPtcd under authority of I.C.36-7 c[seq,Gcneral Assembly oCthc State o(Indiana�and all Acts amendatory
therem: 1 furtherfff ertiFy tfiat only kitcfieq bath;and Flwr dreins are connected ro ffie wniary sewer. 1 further certi(y that the construc[ion will not be
usc r oc uP���fiyI�til a Ccrtific�tc ofOceuPancy has bccn issucd by�hc Dc m t ofC�o ymuni[y Scrviccs,Carmcl,Indiana.
� ✓„- �i..� ✓t.-�;�/ � 5 i4
SlgnaWre a!Owner or AuthorizeA Agent Prin4M Name DaM
�.....................................................................................:� ...............................................................................................�
REQLIIRED BASE INSPECTIONS * '• PERMIT FEES
*Additional inspections may bc re9uired. c Filing/ Review �� Re-Revicw
E Base Inspeclions � � </�
Lower Footin Rou h-In Final �
� g �,�/I7_ g � : Cert ofOccupancy �� Other
:��UPper Footing qp/� Me[er Base �j Site 1 �Q (J.-.`7/ry'1
� /- /_ � P.R.I.F. �(]�L w
� ❑ Underslab T TAL , '��`I ��• �C 7�J
� ._, �-��I�IW : : �� . � - ���-��f— :
% Re��ed/Released-DePutment o(Commmti[y�Senitts e � ; F<e Received-DeP e uf mmuni[y$endres �r Ua[e ;
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