HomeMy WebLinkAbout14070064 Application o�yoF�
�°a-� CITY OF CARIVTEL / CLAY TOWNSHIP PERMIT # (�����'�
RESIDENTIAL IMPROVEMENC LOCATION.PERMIT APPLICATION Sewer / WaterUtility
� �noux' .� For,New Structures,A[lditions,Remodels�and Accessory Structures P¢rmit�$
BUICDER� NAME�� PHONE � FAl(
oF �a�Q�d ,c,, ��✓k: 3iz—.a�3-4¢.�3
. ..
RECURD '�EE7"AODRESS CLfY� SfA7E ZIP
' 3P�.S"E%oL��� _5�• Gar...c-/ r.�. .r�Ge33
' �E-MAILADDRESS� -BEST,MEfHOD�OF.
�RS.+-t.r/l � SBc G'd.b�./ ..��1' CONTACT 4f'3�4�¢33
�PCUMBING': NAME " STATE OF3NDIANA PLUMBING CODE
CONTRACTOR tICENSE'NUMBER ❑ IRC ❑ UPC
PROPERTY NAME �PNONE FAX
OWNER /��r�7d Du.e.v5 : C<rinc-/
STR./E�ETA/�DDRE,SS � CITY STATE 2IP
��_ �: � �CPC;� I LM. �.✓ri'IC.� �IV'. M✓� �Z-
PRO7ECT LOTNUMBER iSUBDIVIS NN " IC; SECfION
COCATION �I �
STREET ADDRE55 � � 'CI � STATE ZIP
� a.
TA%MAPPARCEBNUMBER/'����' 7� ��/''� �ZONIN � FLOODZONE/S
�_ : . lW��,.l v.. �7 "r�u, :
LOTSPLIT SEWERUTILITY WATER�UTI . W ER-
C]�YES ❑ NO ' - -CAVATOR -
� TYPE�OE T�'PE OF CONSTRUCTION MAS7ER�PERMI7 FLOORPLAN ,
_ �� :
PERMIT ��!S�NGLEFAMILY 0 TNOPAMILY � TOWNHOME � YES 0 NO
TYPEOFIMPROVEMENT �� �� ppF' EARLY RELEASE
❑ NEW STRUCiURE �'R�.�3II� '�IBW� 0 DETACHED GARAGE � DEMOLITIONUILDING �ES �q NO
❑ ADDIT[ON—O Room/5� rJ��4�1'R�
' PRU�ECT � P�N�COMMISSION/B � OC�K�L���f ESfIMATED COST SQUARE FOOTAGE
TACDATE/5 SpbfP.0 0 Ompi OFCONSTRUCfION, � �
. Of$�y�@ypa�1aG21�Od05 EXCLUDINGLAND� I�/�OO /�
PDFPLANS 7YPE OFFOUNDATION + ' NUFACfURED SUMP PUMP PORCH
'O CD ❑ E-MAIL � S�B �� ��I(�0�T(��� ��TOWNS USSES ��
� q CRAWLSPACE O � � �I(����EI?P09F&PIER �O.YES' ,O ND 2f YES O NO O YES q NO
STATE OF CDR NUMBER RELEASE DA CONS7RUCTION TYPE OCCUPANCY CLA55
INDIANA
CDR SCOPE OF.RELEASE � TYPE OF RELEASE
� FORSOWNHOMES ❑ FDN O STR � ARCH �.❑ ELEC� 0:MECH� 0 PLUM � SPKLR ❑ OTHER'
For$ingle Family and Two Family Dwellings this Permi[is valid only if construction cummences within�180 days of the date of issuance ofthis permit and
. ...._. ...... . _
ml�st 6e completed�having the Certi£cate of Ocwpancy,�ssued within I B months ofthe date of is5uanct.Class I StrucWre Permits are subject to the State
oElndiana General Administrativc Rules(GAR 675IAC i2)-reparding exPiration�time frames for begin�ing and completing consvuction.
.I��he unAcrsigned�agree t6at any.rnnstruction�recoustruction�enlargement,relocat�on;or alterdfion of a stru�YUre,or any change in the use ofland or
stru�YUres requestedby.this application will comply with and conCortn m all apPlicable laws of[he State oFlndiana and the°Zoning brdinance of Carmel
Indiana=1993"(Z289)and amendmenis�adoPtedvndcr authority of I.C._36-0 e[sey,General Assembly oCtheS[ate oElndiana,and all Acts ameuda[ory
thereto.,l further certi(y tKat only kiteFiFen�bath;and floor drains are emnecMd to ffie samtary,sewer. t further certify that the construction will mt be
used o�rf cupied until a'Certifica�e ofOcewpancy Fas bcen issued by the DePartment of Community Services�Larmel,Indiana.
�/!�!�>.sP�1 �. �.�..lJ �e:�e td /.,., ,S.'r../K ////Y-
Signa re of Owner or Authorizetl Agant � ��Printed Name afe
. .._ .. . _._'_. .. . .. . _. _... . ...
�......................................................................................4 ;.............................................................................................�
' REQLIIRED BASE INSPECTIONS * PERMIT FEES ` :
*.Add�tional��inspections may bc�re9uired. i Filing/Review I���� Re-Revie�v
? BaseInspections l�_�, �
: ❑ Lower�-Foo6n � Rou h-In` Final. .
g ,� g � ' Cert.ofOcwpancy �:� Other�
� � ❑ UpperFooting � � :Meter�.Base ❑ Site � : c - :
. . : P.R.I.F.
��❑ �Underslab ' ' ���J 00 •
TOTAL _ � 1
'� ,l,u �- � - ���" l� �iDVn S-,�.�,� `" 7�1 � I �f-
. % 2e ewed/ eleaeed eparm�en[o(CommunityServices Uace � FeeReceived-Dep ent � �mmunity-Services � �
�......:.i::::::t..........:.......:..................................................d �...:.:::..:..::...:......::.. ...............................................................i
. _ _ . . .___. .__ '
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