HomeMy WebLinkAbout14060011 Revision Info �WuNo.ca�_
� REVISION / PLAN AMENDMENT
_�� a " For New Single Family or"Other" Residential type permit projects
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�`'°�• °° s" Cit o Carme!•De artment o Coinnuenit Serviees
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PeYmit has been issued: � Yes No. If yes, PEfL�IIT #: �?' � D �� �l
NAME:. � PHONE: FA%:
RECORD �f f�VV1 C� 1 �U ! ' •�I �— � 3�0
STREET ADDRESS'. �m: STATE' z�P.
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BUILDER'S EMAII ADDRESS: BEST METHOD OF CONTACT:
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LOCATION L0T x' suemv�sioN NnMe: sernoN:
& PROJECT g �
INFO: ADDRESSOFCONSfRUCiION:
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AR A A�FFECTED BY EVISIOPI: �� OF CGNSfRUCTION:�L� � Z NEW FOUNDATION NPE: �_i SLAB C CRA`NL SPACE
� —� ppST&BEAM _� BASEMENT (Walkou[_Y'_N)
�IF PLANS�FOR REVISION/AMENDMENT ARE PAR7 OF THE MASTER PERMIT PROGRAM; NAME Of MODEL AND REFERENCE#/ID OP
PLANSPECIFICATIONS FOR THIS WORK:
DESCRIPTION OF REVISION: ��� � s �
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6 �.
NEW DESIGNATION OF AREA OF WORK SOUARE FOOTAGE:
BASEMENT 1" Floor 2nd Floor 3`" Floor Front Rear Parch Total Sq. Ft. TOTAL
(Finished and Porch or of Garages
Unfnished Sunroom
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ho�Si�glc Fnmily and Twa F.unily d�vellings,addi[ions,-remodels,:md/or accessory struc[ures,this permi[is valid only if cons[n�c[ion commences
wi[fiin!80 days oF the dace uf issuanm of the building permi[,;md mus-c be completed(Cer�iPicxce of Occupancy issued)wi�hin l8 mon[hs of che
issuxnce da[e.�Class I struc[ure permi[s am subjccc m the Generat Administrative Rules uf the S[ace o(fndiana(See 67�IAC l2)rea�rding espirncion
cime.frames For 6eginnine and comple[ing construction.
I�the undersiened,.ag�ee�ha[a�}'eo�seruc.ion,reconsmiction,znl�,ugemeo�,reloca�io�,o�aleera�ion oF astrucnice,.or any eh;uige i�[he use of land o�
svuceures requeseecl 6y diis.�applic�cion will mmply��2�h,and conform[q.ill applic:�ble laws of the Stu[e of Indiina,and�he"Zoning Orttina�ce of C:umzl
Indiuna—t993"(Z-289)�and amendmznu,adopced u�cle�auehonry o[LC.36-7 e[seq,Genecal d,sembly of[he Scuce o[I�dlana,a�d aL Ac�s omzndumry
ehzce[o. I ulso ec�tify cha[only kiechen,liach,�,md Eloor dmins are con�ecced co che sani�ary szwer. 1 further rerciFy,undec che penalties�uL Perjury(Indiana
Code SS-�#4-2-I)cha[nll oLche inlucma[ion 1 have provided in this Applica�iun and o�her documentacioii is cnie and accurace eo che best of my
knowlcdae and belicf,and tha[I have noc Irno�vingly or intencion:�ly provided or umitted.iny inEorma�ion�hat would cend to hide,obscure,or
o[herwisemislead che Depc.of Communiry Services ce�arding the[ruch of[he macrers eddressed. I also agree chat che co�structiun will not be used
or ncai ied un[il a Certi(icate olOccupancyhas been issued by�che Departmen�.of Co munity Scrvices,Carmcl,lndiana.
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i re�o wner or Autho d Agent Print Date
OFFICE USE ONLY: ****s**r*x****'******"`***»***x***********sxx«**s********s*.««r*x*x**s**x
NEW INSPECTIONS REQUIRED: PLAN AMENDMENT/REVISION FEE:
Upper Footing Lower Footing UnderSlab ADDITIONAL SQUARE FOOTAGE:
RougH In Meter ease Final Site NEW INSPECTIONS REQUIRED:
pf additional ins0ections o[her chan what already remain on the existing permit are requiretl.)
TOTAL:
Reviewed/Approved:� Dept:of Communiry Services (Date) oa[e
S:Permits/Po.mslPlan nmend Resi7ential Fee Received by'.