HomeMy WebLinkAbout14070144 Application ` `��v""�� CITY OF CARMEL / CLAY TOWNSHIP PERMIT # ��[�
,� � RESIDENTIAL IMPROVEMCNT LOGATION PERMIT APPLICATION Sewer / Water IItility
yxo��N�, For New Structures,Additions,Remodels,and Accessory Structures PermiY�$L��3
BUILDER NAME PHONE FAl(
�F Wf.OLEwvoJ Pj:+µ.os.+u �S'i.++oc.v� L''�)(ci,.��-(�.3:`.i �311� t�o't- b3oi
RECORD �REETADDRESS CITY S7ATE IIP
32 �ti� � Srzce.- �+E Cnoy.�.E.. x..i 4�0:,-�
E-MAILADDRESS BEST METHOD OF
CONTACf
�UWEN� wEOLEwWa bG,�o:v� E�"��^��
PLUMBING NAME STATE OF INDIANA PLUMB[NG CODE
CONTRACTOR l. •A� ^��-`�o��c4� �ICENSENUMBER �4iO20iT7lolo�j � 1RC O UPC
PROPERTY NAME a r� �„ ��. � 1I �
L�. � {� �
OWNER �n� As 4,� �E -
STREETADDRESS C STATE I ZIP
JUL 2 3 2014
PROJEC'f �OTNUMBER � UBDIVISIONNAME SECfION
LOCATION ���"'� �
STREETADDRE55 . STA7E ZIP
I�O�ii T0..�E13WCJ LqwE LAQwnf-L 'iw� 1-�V,i>
TAX MAP PARCEL NUMBER ZONING FLOOD ZONE/S
I�I'IO�" �3— DO ' 03�- OG\ .UOCi S-� �(- J/-15HAil:�'l�
LOTSPIIf SEWERUTILITY WATERUTILI7Y SEWER/WATER
Q YES f6 NO (i.'.. �� UTILITIES EXCAVATOR L J N 4\i
�1a..�nEL l.xtY vc l�QanGL
TYPE OF TYPE OF CON5T0.UCTION MASTER PERMIT FLOORPLAN
PERMIT � SINGLE FAMILY Q TNO FAMILY O TOWNHOME L� YES � NO
TYPEOFIMPROVEMENT EARLY RELEASE
� NEW STRUCTURE O REMODEL O ATTACHED GARAGE � ACCESSORY BUILDING
q ADDif10N-O Room/s O Porch O Deck q BASEMENT FWISH ARAGE Q DEMOLITION q YES �i NO
PRO]ECT P�N COMMISSION/BZA/BVW DOCK� COST a SQUARE FOOTAGE
TACDATE/5 '7�2D,412 � g`�
Subjec�to compliance wl� ��4u���NON� r� �3�
PDF PU1N5 TYPE OF FOUNDATION - SUMP PUMP PORCH
❑ CD O E-MA[L O SLAB � BASEMENT-Ca W� � F COMMUN�' `µ�,I�7� o
� CRAWLSPACE O POST&BEAM ��TOy�,Dq3I1Ll NO � YES O NO � YES � NO
STATE OF �DR NUMBER RELEASE INDIA kONS7RUCfION TYPE OCCUPANCY CLA55
INDIANA
CDR SCOVE OF REIEASE 7YPE OF RELEASE
FORTOWNHOMES O FDN 0 STH � ARCH 4 ELEC O MECH O PLUM Q SPKLR O 07HER
For Sin�le Pamily and Two Family Dwellings this Permit is valid oniy if construetion commenees within I RO days o(the date of issuance of this permit and
murt be completed,having the Ccrtifiate of Occupancy issued,w�ithin IS monffis ofthe Jate ofissuanca Cla+s 1 Structure Permits are subject to[he S�a[e
o(Indiarr,m Ceneral Administrative Rules(GAR 675 IAC 12)regarding expiration[ime framen(or beginning and cumpletin�construaion.
1�the unde'signed,a�rec that any construclion�rctonstruction�enlargemenq rdocation�or alteration of a slructure,or any chany�c inthe use of land nr
s VuRUres requcsted by thi�aNplication will comply with and conlnrm�to all applicable laavs of the State of Indiana and the°Loning brdinance olGrmel
Indiana-1993"(%-289)and amcndments,adopLCd under authority o(I.C.3fi-7 ef seq,Gcncral Ansembly o(thc Statc o(Indiana,and all Ac[s amendatory
lhere[o. l(urthe rtifytha[onlyki[cheqbath�andlloordrainsareconnecf esam sewr. l(urthermrtify[hatthemnstructionwillnot6e
us or oc p' d u til a Certificate of OccuPancy has been issuedby the D artmen o(CqIm�um Services,Grmel,Indiana.
�� � A�� �C�.� � t3 1
Signature o/Owner or AuMOAZaA Agen[ Pri�tetl Name Da
�......................................................................................• :..............................................................................................,
REQUIRED BASE INSPECTIONS * '• PERMIT FEES y°�
*Additional insPections may bc reyuired. c Filing / Review ` v3a�.�a Re-Re��ie�v
E Basc Inspections - �
: �Lower Footing �Rough-In �Final rn��F.
: Cerl,of OccuPancy �( V Othcr
: � llpPer Footing Meter Base �+Site
( � � P.R.LF. (�,�-I-?. Db
� ❑ Ilnderslab l ,
/ TOTAL 3a�a _�a
�l ��� 7-Zg'/� € 7��,���l,l,k�. -� --��-�� :
; Re�iewed/Releascd-UePartment of Community Services Dare ; Fee eceived-De rtm t of ommunirv Senices �Uaze ;
�......................................................................................i �....................................:.........................................................�
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