HomeMy WebLinkAbout14060194 Application �""�� CITY OF CARMEL / CLAY TOWNSHIP P IT # ��q'
- � RESIDENTIALIMPROVEMENT�tOCAT10N�PERMITAPPLICATION � � '''yf�\ Sewer /�WaterUtility
�noux� � For New Structures�Additions�Remodels,and Accessory Structures J" Permit�$1��
BUILDER naMe PHONE FA%
OF �Q ��c�AI �NS}/' C� � L �J Z
RECORD �STREETADDRE55 � CIfY - � STATE IIP
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E-MAILADDRE55 BESTMEfHOD OF
a V� �� ' f A�i �O M CONTAR I'��ON e '
PLUMBING nane STATE OF INDIANA PLUMBING CODE
CONTRACTOR (��'/�jAM �O��or.{. LICENSE NUMBER o tac o uac
PROPERTY NAME PMONE FA7(
OWNER �[.✓�
STREET ADDRE55 CITV STATE ZIP
PRO7ECT �OT NUMBER SUBDIVISION NAME SECfION
LOCATION 3 W i .� G�� CI<i �p0
STREE7 AD RE55 . CI7Y STATE ZIP
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TAX MAP PARCEL�j�BER: �� �+ ZO�� FL�ZO��S C�
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LOTSPLif SEWERUTI WATERU7ILITY SEWER/WATER
q ves o No �, i2 L(f �, � UT1LITfES EXCAVATOR / -.Na/�
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TYPEOF TYPEOPCONSTRUCTION MASTE0.'PERMIT FLOORPUIN
PERMIT �NGLE FAMILY 0 N/0 FAMILY Q TOWNHOME Q YES O NO
TYPE OFIMPROVEMENT EARLY RELEASE
EW STRUCrURE 0 REMODEL L� ATTACHED GARAGE O ACCFSSORY BUILDING
ADDITION-ORoom/s OPorch ❑�Deck O &45EMENTFMISH ;O DETACHED.GARAGE � DEMOLITION O YES �NO
PROJECT P�N COMMISSION/BZA/BPW �' BER/S AND/OR ESTIMATED COST SQUARE FOOTAGE
7ACDATE/S SUb�Q���fO F�R E%C UD NGUINDN� S �� ( I
PDFPLANS TYPE OFFOUNDATION /��. pf(,_ %dq� ��RED SUM PUMP PO CH '
❑ CD � E-MAIL 4 SLAB �ASEML9YIC-�W(�K,OUi��te��,.� e w�� �p, /n^.
Q CRAWLSPACE O POS ,�.� �. `�f] . .: PIEitLO� � ll.�eg(j � V2SV�IPO �'PES 0 NO p'YES Ca NO
STATE OF �DRNUMBER RELEA A RM�L N�T Sc RUR .r= � ��S �
INDIANA � �R �
CDR SCOPE OP RELEASE �A^/ le: TYPE OF RELEASE
[� ry�/('
�FORTOWNHOMES 4 FDN O S7R O ARCH Q ELEC O MECH Q rwM Q�5➢KLR 0 OTHER'N I 7
For Singlc Family and Two Family ITvcllings this Pcrtnit is valid only if construction commenccs within 1 8days of thc datc of issuancc of this crmit and
mustbewmpleted,havingtheCertificateofOccuPancy.issued�wilhinl8monthsofthedateofissuance. I?��n.4S[ �� •��P,••m:r=or�syli( mthe$Wtc
of Indiana Geoeral Administrativc Rules(GAR 675 IACl2)regardinp exPirecion time frames for beginnin�and comP et�n�constnchon.
I�the undcrsigned�agrce that any construction�rcconstru�tion�enlargement,relo�'ation,or niterecion ofa sVUCture�or any change in the use ofland m
s[ru�tures reyuested by this application will comply with and conform�ro ali aPPlicable laws o(the SU[e of Indiana and the°%oning brdinanec oFCarmcl
Indiana—1993^(Z-289)and amcndments�adoptcd under authori[y of I.C.36J et seq�Gencrel Assembiy o(thc State of Indiana�and all A�YS amendatury
thereto. 1 Curther eertify that only�kiichen�bath�and�floor drains are connceted to the sanitary sewer. I further certi(y that the construetion will not be
used cup�e unt' Ce dicate f t�cu hasbeen issued by the Department of Communi Scrvic Carroel�Indiana.
�,� `�� s���t�P i�l�iti ;,� -30_
. g reo� n utlro' Agent ' Pri tetlName Dace
' �......................:.........:::...................................................• :.........................................................................:...................�
REQLIIRED BASE INSPECTIONS * '• PERMIT FEES
*Additional inspections�may bc required. E Filing / Review �� I Re-Review
: 6aselnspections ��
:��Lower Footing � Rou�h-In � Final /_� I��/y
c Cert.of OccuPancy vi %v Other
� UPPer Footing �Meter Base �Site
� P.R.I.F. 1,;���`� Ob
� ❑ Underslab OTAL ��6'�`• �I
' V�� � : :� 7 �� ��'� �- :
; Rev�eaed/�Releasea--DePar[men[ofCommunityScrvices Uate � ; Fe Re rvel1- ) artnent (Community5ervicen Da[e ;
f...............i.i:..... ., .. -. : . . .. , ..........................................�
.................................................................: �....................................................
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