HomeMy WebLinkAbout14070073 Application -- - llJ� �.-
`�<�a��. CITY OF CARMEL / CLAY TOWNSHIP ` PERMIT # � �
RESIDEN'I[AL IMPROVEMENT LOCATION PERMI�T APPLICATION Sewer /�Water�IItility �'JJ
�x���,x �� For New Structures,Additions,Remodels,and''Accessory Struc`tures Permit�$� -+!' �� / /
BUILDER� n^ME PHONE': FAX
,Or.�. '��.IIrG7L�JUO�i Qei��lYwlf.a Cu:'N04w/{. '.71:/,-GO4�A'1\S 3Y)-�4�� � �r '�U\
RECORD �TREE'L'ApDRESS CITY SfATE ZIP '
.i3 \st ��.�,.sa NF_ 'Cw;sn�� 2N :.il.c1Z
E-MAIL ADDRE55 ,BESf MEfHOD�OF��
._ . F � w..d� cwrx�\bc .cc..n CONTACT E ' M,S�-
P�w _..�
�PLUMBING� NAME .STA7EOFINDIANA PIUMBINGiODE
CONTRACTOR L_�• M�°�4^i s�4i- LICENSE NUMBER � IRC 0 UPC
PROPERTY "aMe PHONE FAX
OWNER
STREETADDRE55 f �jn� I� f � A7E ZIP
:i4w±_E _ s5 h 30 � l�J tS II LJ �
PRO]ECT �OT NUMBER SUBDIVISION NAME SERION
LOCATION `�3 C��z4NasN 1.�1AL �
5fREET ADDRESS . C A ZIP
�)"�4S �S24ND�w! �16i� C'C2[_�� � L4�Q.N.Et� "LN '�btJ.�a.';
TAXMAPPARCELNUMBER NING FIOODZ NE/S
17 ' 10 - z\ - �0 ' 22- GM3.;G00 . . X' ur+�S.�4oE0
LOTSPLIT 'SEWERUTILITY WATER�UTILITY SEWER/WATER'
O YES O NO C .�,gpMEt, U�:L. CqM+C� v-�. �UTILITIESEXCAVATOR L �NAR
TYPE OF TYPE OF CONSTRURION MASTERPERMIT FLOORPUIN
PERMIT � SINGLE FAMILY � TWO PAMILY 0 TOWNHOME � YES � NO
7YPE OFIMPROVEMENT EARLY RELEASE
� NEW STRUCTURE O .REMODEL O ATTACHED GARAGE q ACCFSSORY BUILDING
O ADDITION-O Room/s q Porch �Deck q, BASEMENT�FINISH O DETACHED GARAGE 0 DEMOIiTION q YES �.NO
PRO]ECT P�N COMMISSION/BZq/BPW DOCKET NUMBER/S AND/OR ESTIMATED COST SQUARE FOOTAGE
7ACDATE/S OFCONSTRUCTION, �.,� �p\ , �+C
� EXCLUDING LAND� �� �+ �� Z-,�lo
POFPLANS TYPE OFFOUNDATION 'MANUFACTURED �SUMPPUMP PORCH
❑ CD O E-MAIL � �'. B�EMENT-OWALK-OUT� TRUSSES
O� CRAWLSPACE q' POST&�BEAM -q POST&�PIER� � YES O NO '� YES O NO � YES q NO
STATE OF �DR NUMBER RELEASE DATE CONSfRURION NPE OCCUPANCY CLASS
INDIANA ��
CDR �SCOPE.OF RELEASE � � �S TYPE OF RELEASE
ti�0
FORTOWNHOMES� 'O FDN �O STR 0 ARCH �R ELEC O p��M O R O OTHER
� - y�'�..:�paes� \
For Single lamily and'fwo FamBy Dwellin r�(f�4\s�'� c � ion mmmences wLLhin IRO days of the date of issuance of this permit and
must be compieted,having the Certifi ��?��c�,'�l� �.months of the date ofissvance..Class I$tructure Permits are subject to the State
of Ind�ana Grneral Administrative Rules GA'$�675 IA@�� �` a di � vakion time frames For beg nnmg aod comp�etinp construction.
a`
I�[he undersigned,agree thaY any construction�re 6w�(l� o�n nq rebcabon�oralterehon o(a structurc�or any chanpe in the use of land or
struRUres reyuested by,ihis application will e �y w�1��� to all applicablc la�vs of the Statebf Ind�ana and the"Loning brdinance ofCarmel
Indiatia-1993"(Z-289�and amendments,ado��tlt�deYauthorf ,oLI.C.36 7 ef sey�Genc�al Assembly:o(the State of Indiana{and all Acts amendatory
)•
�thereto. 1 further certify[fiat only kitchen�6 llooi drains are conneRed[o ffie saniGry sewer 1 furt6er certify,thai the consiruction will mt be
used or occup/1Ied unf a Certifiate of OeeuPa y 6as�been isaued by the DeErartment of Commumty Servicea�Carmelq Indiana.
/S/�✓ �.fct� SUE Co.��aaT 7 1� ��
SignatureofOynerorAUN 'zedAgent ' ' ' �PrintetlName - - - � Date
�.............................................................�.........................� ;.............................................................................................�
REQLIIRED BASE INSPECTIONS * PERMIT FEES
,y :�Filing /Review �,� r �. . Re-Review
Additional inspections��may 6e required. ''7 �
,� / [ $ase InsPections _�J _�
: LA/ �wer Footing � Ro gh-In � al �.`Z r�
( � � c.Cert.of OccuPancy �._� Other
❑pPer Footing ❑ eterBase Site [r Cp
; P:R.LF.
� ❑ IInderslab � � �/y ,�
OTAL ' .�
; Rev�ewed� Rel s d De aRm t f C mmvcu Services: Date � ; Fe�ved D ' r[mer[o�Commu S m Uare ;
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S:�Penvi[s�FOrmslApptiniionslResidenciaM.PApPiicaiiov�2009;08� L �s�UpOaeed08/13I201M