HomeMy WebLinkAbout14070137 Application .�
`��'"?�� CITY OF OARMEL / CLAY TOWNSHIP PERMIT # �D��
RESIDENTIAL.IMPROVEMEN'C�LOCAT[ONPERMIT APPLICA7'ION Sewer /�W(a�t�er Utility
+noux�� For New Structu�es,Additions,Remodels,and Accessory Strvcfures Permit�$I'f�/�D( 3�
BUILDER NAME PHONE FAX
oF a rn;e �/°4, �'i y -d FS-9
RECORD STREEf A RESS CIfY STATE ZIP
3�P5� r, o„ !J 5 /,Jr d ls ti �ay6
E-MAILADDRESS BEST HODO
V � � � 0 CONTACf � 4/ �
PLUMBING Nawe STATE OF INDIANA PLUMBING CODE
CONTRACTOR �4�// �� a LICENSENUMBER ���aSG� C y IRC O UPC
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PROPERTY NAME PHONE FAX
OWNER an ��r� 6�� �'f�.21L�
STREET A DRESS CITY�/ / TATE ZIP
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PRO]ECT �OT NUMBER SUBD VIS ON AME SECTION
LOCATION ?✓'S i �
STREETADDRESS , CITY �ST TE ZIP
/S� S � -�f r !-� �f G r ti-e� {� / 0,�3
TAJ(MAP PARCEL NUMeER FLOOD ZONE/S
/ 7-/o -��-aa-36-oz&• v� v / .� uhs� rd
LOTSPLIT SEWERUTILITY WA7ER�U7ILI7Y SEWER/WATER
� YES ��NO �//j4 / �/�p / UTILITIESE%CAVATOR �� � C�O �
TYPE OF T�TEAf CONSTRURION MAS7ERPERMIT FLOORPLAN
PERMIT SINGLE FAMlLY O N/0 FAMILY O TOWNHOME Q YES �NO Sc pL S G G��
PE OFIMPROVEMENT EARLY RELEASE
�. NEW STRUCTURE O REMODEL 0 AT7ACHED GARAGE ❑ ACCESSORYBURD[NG
O ADDITION—O Room/5 O POrCh O DeCk �. BASEMENT FINISH O DETACHEO GAR4GE �O DEMOLITION 0 YES �NO
PROJECT P�N COMMISSION/BZA/BPW DOCKET NUMBER/S AND/OR ESTIMATED COST SQUARE FOOTA6E
TAC DATE/5 OF CONS7RUCTION, �Q� Q�� / 7/ /
• EIICWDING LAND ��� (9 �o
PDFPLANS TYPEOFFOUNDATI N MANUFACfURED �SUMPPUMP PORCH
❑ CD q E-MAIL O SLAB �BASEMENT—q WALK-OUT TRUSSES
O CRAWLSPACE POST;&BEAM � POSf&PIER YES O NO YES � NO �YES O NO
STATE OF �DR NUMBER RELEASE DATE CONSiRUCfION TYPE OCCUPANCY CLASS
INDIANA �s � �
CDR SCOPE OF RELEASE E�A E �� L�
.FORTOWNHOMES Q FDN Ca STR O AR6H O ELEC 17 MECH � PLUM O SPKLR O OTHER
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:For$inglc'FatnilyandTwoFamily.Uwellings�tbisPermiCismalidonlyifconstructioncommenceswithin180d softhedateoCissuanceofthispermitand
must be completed,having the Certificate oCOccupancy,issued�within 18 months of the date ofissuanca Cla s�IStructure Permits are subject to the SGte
uf Indiaru Ccne al Adminis[ralive Rules(GAR 675iAC I2)regarding exPiretion time frames for beginnin�an m Icting mnstruc[ion. �
7�[he undersiKned�a�ree that any construction,reronstructiion�enlargemenq relocation�or alteretion ofa st �`'SiangC�n.tN�,lise;aFlajnd or
sVURUres requeetcd by tfiis application wdl comply with and conform�to all aPPlicable Isvs of the State of lnd�ana and the°'Loning brdinance of Carmcl
Indiana—1993"(Z 289)and amendments�adoPted under authori[y oCLC.36-7 e[sey�General Assembly o(the SGte of Indiana,and all Ac[s amendatory
t6ereto. I�further cer[dy.that only kifchen.bath�and flou�drains are conneRed t�the sanitary.sewer. 1 Further rertify that the cv�nstruction w� not �
�used �cuDi�until a�C ilnte Occupancy has becn issued by thrDCrar fue4�t of Commun ervices� rmel�Indiana. ��
� � h,,.G�' /
�Signature of Ow ror AutlwrizeA Agent Printed Nema . Data
�...................................................::.................................� ;.............................................................................................�
REQLIIRED BASE INSPECTIONS * � PERMIT FEES
*Additional inspections may be required. c�Filin� / Review � ��� ���q Re-Review
t Base InsPections �c��_ ._JlJ
:�jLower Footing �Rough-In � Final I�,� ��
' Cert ofOccupancy w Other
� :�, UpPer Footing �Meter Base �Site 1 Q(+� !`O
I ' � P.RLF. 1 v V
� ❑ lInderslab
I i OTAL 3 � �, �I
;- ... �� ' �� 7i�'�Ll ' . -"J .
;`fte��ew�ed/Releued DePartment of Commwu[}Semce� Fee ece eA U rtm t n Commumey Serncec ✓ Da[e
f. ....L ........ .::'.: �.....-..:::.�.�..:t............r r . ...... . ............:.:.......................................................... ..i..
1 itsNOrmsUppLCationSResdenosM.PAppLCation@009-08' Ias�UpdazW08l132009