HomeMy WebLinkAbout14070059 Application _ �\
'�'� CITY OF CARMEL / CLAY TOWNSHIP PERMIT # I �I'070���
REStDENT1AL IMPROVEMENf LOCATION�PERMIT APPLICATTON Sewer / Water[Itility
/MOI�M� For New Structures,Additions,Remodcis�and Accessory Structures Permit$�
BUILDER NAME PHONE 7�/�Z FAX 3���
oF C�s� D�s� t3�MO1�� 6 2 0 � Z6o
RECORD �EEf ADDRE55 CIfY STATE ZIP
LO . G MF� � ✓E C ri�� l f 03
E-MAIL ADDRESS BE :MEfHOD OF
I N�Q - � I/v'� . C�0/"� CONTAR /OO
- (O
PLUMBING NAME STA7E OF[NDIANA PLUMBING CODE
CONTRAGTOR LICENSE NUMBER [J �RC Q UPC
PROPERTY NAME PHONE /� FA%
OWNER , �- o,�.� � a� s o o .�_-�
10�R�Zlf/ ��� s� cm �E` ��� < �"- 4�03
PRO]ECT �OT N MBER /SU.B/DIVISION NAME SERION
LOCATION �� �viivDb M � '� - �g ���4
S7REE7ADDRE55 . CITY-� STATE 2IP
�06� /� o�P.4 g� e �ric� / � 0 3�2
TAX MAP PARCEL NUMBER Z G ZONE/5
i�-�3 -,e�9- ;�12,� .,�-, s-= �C U,�s E
LOTSP�17 SEWERUTILI7Y WA7ERUTILI�1'' SEWER/WATER
o �5 o No =' /-1- G A� i'��L ���ES E%CAVATOR � a �J �C
TYPE OF T�TE OF CONSTRUCTION MASTER PERMIf ORPLAN
PERMIT SINGLE FAMILY O TNO FAMILY 0 TOWNHOME O YES I�NO Q ZQ�4
7YPEOFIMPROVEMENT EARLY ELEASE
CJ NEW STRUCTURE � REMODEL O ATTACHED GARAGE ACCESSORV BUIlDING
I�ADDRION-O Room/5 O Porch 1�Deck q BASEMENT FINISH O DETACHED GARAGE q DEMOL[TION S Q NO
PROJECT P�N COMMISSION/BZA/BPW DOCKET NUMBER/5 AND/OR ESTIMATED C057 � UARE FOOTAGE
7AC DATE/5 OFCONSfRUCfION, ���
D /
PDFPUINS TYPEOFFOUNDATI SUMPPUMP PORCH
0 5ue pq yyq��'-ct to compliance wi heYueg6�ions
CJ CD O EMAIL 4 CRAWLSPACE � ST&BEAM q. vosr.Bf Blfif�andloc I.Cotles O YES 21',.NO Q YES 0 NO 5 Q NO
STATE OF �DRNUMBER A MMUN l�'3�If��'ryPE OCCUPANCYCLASS
INDIANA �IlY
CDR ��PE OF RELEASE 1�,'n���n 7YPE OF RELEASE
FORTOWNHOMES R FDN CJ 57R Q ARCH Q ELEC Q MECH CJ PLUM j��� r�� OTHER
For Single Pamily and Two Family Ihvellings this Permit ic valid only ifmnsvuction commences within I80 days ofthe date ol'issuance of thie Permit and
must be compleMd,having the Ce�tificate oFOccupancy issued,wilhin IB months of the date of issuance. Class I 5[ructure Permits are subject to the State
of Indiana Ceneral Adminis[rative Rules(CARb75 IAC 12)regarding expiretion time Games for beginning and completing cunsWCtion.
1�the undereigned�agree that any construction�reconsVUCtion�enlarPement�reloea[ion�or aiteration of a structure,or any change in the use ofland or
strunures requ d by this application avill co with and confnrm to all aPPlicablc laws ofthe Statc of Iediana and the°lonin�.brdinance oFCarmcl
Indiana-1993 289 and amendments. oPted der authority of I.C.36-7 ei set��Genenl Assembly of[he Slate of Indiana�and all Acts amendalory
thereio. I f h r i that on� kitchen�6ath�an floor drains are mnne�led to the sanitary sewer. I(urther certiCy that the construnion will mt be
used or oc �i d ntil �rtiFi te oFOcc cy ha bcen issued by the Derartmen[ofCommunit��Sernces� armel�Indiaw.
� ����1�
Signahre oi orAUthonzatl p an � Printed Name Da e
�.......... ..........................................................................� ;.............................................................................................�
EQLIIRED BASE INSPECTIONS * '• � PERMI'C FEES
*Additional inspections may be required. c Filing/Review Re-Review
: 6aselnsPections �IF^�=
: ❑ LowerFooting � Rough-In �Final ��_
t Cert.oCOcwpancy Other
: � UPPer Footing ❑ Meter Base � Site
� P.R.I.F. '�.
� ❑ Underslab
TOTAL� �
\� ;���2� 7'l G:-/Y r�-o� `7 a I /
�`Revie� � /�Released-Deparhnmto(CommunirySenlms Uace ; Fee mived-Ue arnnentulConunwiryServices Uate
....................:.....:..:........................................................i �...... ............................:.........................................................i
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