HomeMy WebLinkAbout14070058 Application :�
`����� CITY OF CARMEL / CLAY TOWNSHIP PERMIT # I ��
RESIDENTIAL.IMPROVEMENT LOCATION PERM[T APPLICATION Sewer / Water U—t7ility
�xoux� For New Structures,Additions,Remodels,and AcccssoryStructures Permit�$ � /�� 7
BUILDER NAME PHONE FAX
oF R ,a rn�s �t -�G� 3 �J �- o?G�
RECORD STREETAD RE55 CIfY STATE ZIP
ks P-�o;� s h 7`�Z "b
E-MAIL ADDRESS � BE �MEfHOD OF
/ ���I / CONTAR � '
�/�Y41V�pS . t� ::k ��.od. CC� .�- .
PLUMBING NAME SfATEOFINDIANA �q e �-� PIUMBINGCODE
CONTRACTOR �`. �r� IICENSENUMBER ( (�p�O,✓1d92 bIRC � UPC
�. /C
PROPERTY """'E }� PHONE FAX
OWNER /� N LS � ��G�J �S�%" o�lrSl�
STREET ADDR 55 � CITY STAT ZIP
�,�, . �o ,�i �� .S /i � � � a
PRO7ECT �OT NUMBER SUeDI SION NA E SERION
LOCATION �� � � d �. �'"
S7REE7 AD.S—OS I"Q. �Ii ,'f :'ILC,/ ���1 �6���
a
TAX MAP PARCEL NU BER 20NING FLOOD ZONE/5
, . ,o _ ��-- �- .3� - Ga� . o0o S- i u,�l���
LOT SPLIT SEW UTILITY WATER U7IL�/7y SEWER/WATER I
� YES 0 NO / UTILI'fIESEXCAVATOR � _..I /
y� /��- ��j0/.1
TYPE OF T�E OF CONSTRl1GTION MASTER PERMIT FLOORPLqN
PERMIT �SINGLE.FAMILV O NJO FAMILY � TOWNHOME O YES� NO � ��
PE OFiMPROVEMENT EARLY RELEASE ,
NEW STRUC7URE q REMODEL O A7TACHED GARAGE O ACCESSORY BU[LDMG
� �ADDITION-O Room/s O PorCh q Deck O BASEMENT FMISH 0 DEt�ACHED GARP.GE O DEMOLITION q YES � NO
PRO.IECT PaN COMMISSION/�BZA/BPW-DOCKET NUMBER/5 AND/OR ESTIMATED CO57 L SQUARE FOOTAGE
TAC DATE/S OFCONSTRUCTION,yh•2 � �
� E%CLUDIflG.IAND �rJ n
PDFPLANS TYPEOFFOUNDATIOry, MANUFACfURED SUMP L,C Pb � �
0 SLAB �Q BASEMENT-I�WALK-OUT TRUSSE
❑ CD O E-MAIL f°
0 CRAWLSPACE � POST&�BEAM O POST&PIER YES O NO ES O NO YES 0
STATEOF CDRNUMBER RELEASEDATE CONSTRUCfIONTYCE OCC Y ZO�4
INDIANA
CDR SCOPE OF RELEASE �,` NP gF RELEASE
'FOR70WNHOMES O FDN � STR O ARCH O� ELEC O MECH q PLUM Ca � �\'E7 OTHER y �
� \ai�ot�s
For Single Family and Two Family Dwellings.tSis;Pe �1 ,,`n`,�l��l���e�r^�5ion ces within IRO days ofthe da[e of issuance ofthis Permi[and
must be comPleted�having the Certifica[e of O ��u�pn�' b$�d� � �'issuance. Class 1 StruHUre Permils are subject to the$tate
of Indialu�Ccncral Administrative Rules GAR �g@ � � or beginning and cumpleting construc[ion.
� ��r
I�the undersigned�agree that any mnstruc[ion�rec strucYl�x���o i n�or al[eration ofa strucmre�or any change in the use olland or
struRUres requcsted by ihis applicacion will comPly wit t p�cahlc laws oftMe State oClndiana and ffie°Zoning Ordinance of Cannel
Indiana-1993^(Z-289)and amendments�adoPted �� � � sey�Cmcral Assembly of[he Sta[e of Indiana,and all Ac[s amendetory
thereto. 1 further certify_that nly kitehen,baffi{an��� ar���ed to the sanitary sower. 7 Curther certify that thc conetruction wi➢n t be
used or upied until a C ' �cate of ccupancy�� e ��ssued by t e Ue ent of Community rvice;Carmel�lndiana. �/
il _ �� �cd�. /�„-�, r�i� 7
� �T
SignatureofOwnar uthaizetlAgen[ PrintetlNa a� � Dafe
�......................................................................................� ;.............................................................................................�
REQLIIRED BASE INSPECTIONS * � PERMIT FEES ��Q ��
Additional inspections may be reyuired. : Filing / Review � $e-Review
: sase Inspect�.ions 3a�.5e�
: .�er Footing �_ gh-In �. �� 5O
� t Cert.of Oceupancy Other
❑pper Footing LI Meter Base Site �C�� (`��
; P.R.I.F.
� ❑ Underslab +�
TOTAL � �73 a�• ��
C - ' �rm � -7—I �.° ��__
;ReviewedGReleasA-UepartmentofCommuNtyServices ' � ae ; ; FeeRemived-Depatmev ofCommwityServices Uate
v.................... ............................................. ...... ...........: �.........................................................................:....................i
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