HomeMy WebLinkAbout14070086 Application cy�a W6tr� '
_�`�"°� CITY OF CARMEL / CLAY TOWNSHIP PERMIT #
RESIDEIVTIAL IMPROVEMENT LOCATION PERMIT APPLICATION Sewer / WaYer[Itili���'
�yo��x���' For��New�Structures,Additions,Remodels�and Accessory Structures Permit��t�k��Z����,
BUILDER' ��NAME PHONE Fp7�
oF �is��a,� ���5 ?.!�-'7!'//�/
REGORD ' 'r/�A� �� �� 51- �"�L �� � 5 srar�� Lr���
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E-MAIL ApDDRE55J I� BEST M HOD OF
�a� C� 1/Vi��a� � e!M,/�T3 . GOI'n CONTAR Q���� �
PLUMBING NAME �^ STqTEOFINDIANA PLUMBINGCODE
CONTRACTOR ��T� d' 7�j yL.j LICENSE NUMBER ��Qg ❑ IRC ❑ UPC
PROPERTY a
OWNER E �/! M F P � � � � �
STREEfADDRE55 C STATE� ZIP
JUL 1 5
PRO]ECT �O7 NUMBER SUBDIVISION NAME SEC�ON
LOCATION I9 /�2rJa�"uUIC �i" � /
S�E� / RP2I�RM �O�L(/`� �GrM�P . S7ATE ZY�`I�7
7AX MAPPARCECNUMBER � ZONING FLOODZONE/S
l�7-�-/9'OU '03-.0/9.CJ�0 S � �-u+�sh�
LOTSPLIT SEWE /�1TILI'fY WATER'LTILIfY SEWER/WATER
C,l YES O NO �[h-� ��,�,�„y L / UTILTfIES�EXCAVATOR � �
TYPE OF TYPE OF CONSfRUCTION MASTER PE MIT FLOORPLAN ,���
PERMIT SINGLE FAMILY O PNO FAMILY � TOWNHOME O YES NO f��'ys
�TYP OFIMPROVEMENT EARLY RELEASE
NEW STRUQURE O REMOOEL 0 AIIACHED GARAGE O ACCESSORV BUILDMG
O ADDITION—O Room/s O Porch Deck O BASEMENT PINISH q DETACHED GARAGE q DEMOLITION O YES 1�N0
PROJECT P�N COMMISSION/8ZA/BPW DOCKET NUMBER/5 AND/OR ESTIMA7ED COST L n SQUARE F/OO7AGE
TAC DATE/5 �. . EXCLUD NG LANDN..L�' 7 fl.�� �Jv V ��b �
PDFPLANS TVPEOFFOUNDATIQN� MANUiARURED SUMPPUMP VORCH
❑ CD O E-MA[L � SLAB l,��ASEMENT-�WALK-OUT TRUSSES /�/
q CRAWLSPACE .� POST EAM q POST&PIER � YES O NO �YES O NO uTYES q NO
STATE OF �DR NUMBER TE' CONSfRUCTION TYPE OCCUPANCY CLASS
INDIANA ��CFO
CDR SCOPE OF RELEASE D '�Cp�n � r/� 7VPE OF RELEASE
FOR70WNHOMES � FDN � .57R O �E �A�,���r�llfi`B'/�i � OTHER
r' ����I�� '���: ' �/ C
. 5 _, � .h �
For Single Pamily and Two Family Uwellings this permit�s val� tm1yW 1b�1�j u ottF�m �p ithin 180 days o(the date of issuance of this permit and
must be tompleted�having the Certifirate of Occupancy�ssp �EvjthFi�tJB mdntY�3,ql�the date o�ssuance. Class I Struc[ure Permits are sub)ect to the State
of Indiana General Administrative Riiles(GAR 675 IAC I2)f�/z4�; e.E�'� q t�iv'q !or beginning and comple�ing construct�on.
I�the undersigned�agree that any mnstruct�on,reconstroction� .�ent�f�{.gt���t<rationofa structure,or any<hanKe in the use of land or
strucwres requented by this appliwtion will mmply with and conform o all appl'c�'vq_t+y�?' f the State of Indiana and the°"l,omng�rdinance of Carmel
Ind�ana—1993"(7 289)and amendments,adoPted under authority of I.C.36J M seq�Gct�e)�j{�ssembly ofthe SGte of Indiana,and all Acts amendatory
lh eto. 1 further tertify t6 ly�kitcheq bath�and floor drains arc conn7,�`,.ted to the saniGry sewer. Pfurther rer[iFy that the cunstruHion will�not be
nse occupied until 'e ' - ccu�ancy has been issued 6y the De83ctment of Co ty S v s,Carmel�Indiana.
��a � ���5 7 �y �5'
Signa reofOwnerorAUthorizedAgenE� PtlntetlName� D
.... ............... . ............................................. ..� .. .. ................................... .................................
�.. .... ... .. .. ... ... ...... ;....
REQLIIRED BASE INSPECTIONS *�"� PERMIT FEES
*Additional�inspections may be re9uired. " '� � Filitig'/���Review � 1 u� R�-Review
c /
�, L :-Base-Inspeclions
�1, Lower'Footing�ough-In F�nal
� `i ,-, ����, ��`""� � � � :�-CertofOccupancy �O OtSer
� �J UPperFooting C�MeterBase �te. �,Q � �_-�i�b
� J� � / � ; P.R.I.F. 1. !� V
f ❑. lInderslab / ' I �j �
(� � ` TOTAL , �S' 0
1�-� ��� �� U � u r�1
= Reviev,ed/yReless:d Departm.rnt..fCommo �[ySe.vlaw . Uate ; ; FeeR.cei.ed—DePartmento(GommvuitySenices Date ;
e.........'..:. ....�... .........................................................................
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