HomeMy WebLinkAbout14070101 Application — �4����N ' ' " n
�-' """°'���� CITY OF CARMEL / CLAY TOWNSHIP PERMIT # 1��{-C� i �_' � �' 4
� � RESIDENTIAL IMPROVEMEIYT LOCATION PERMIT APPLICATION Sewer / Wat r IItili
�noux// For New SVUCtures,Additions,Remodels�and Accessory Structures PCrmit# (_ �,L .�
BUILDER NAME PNO FA%
oF ��.d�._ C` �. - � b� �aa
RECORD 5*q� ADD ESS cro srare ziv
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E-MAIL ADDRESS BEST MEfHOD 0
, L. CONTACf ����1
PLUMBING N� ^ STATEOFINDGNA VLUMBINGGODE
CONTRACTOR \ LICENSE NUMBER � �o a3Y �C O UPC
V
PROPERTY NAME . /1 PH FAX
OWNER ��. L 1, �� �lQ 3 �3yc� Yaa
STRE DDRE55 � CITY SfATE IIP
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PROJEC'f �OT NUMB R SUBDIVISION NA E $ECfION
LOCATION V�ILa�.�w� � '—�.� 0.0
STREEf DRESS � CITY A IIP
Y. � .� �� I� �a33
7AX �- �ELNUMBER , , � ZONIN 1 ROOD�U��� f ,
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LOT SPLIT SEWER UTILITY WATER LITY SEWER/ ATER
❑ VES �0 ���'^�-�� ��ES EXCAVATOR `���
TYPE OF TrP F�ONSTRUCfION MASTER PERMIT FLOORPLAN
PERMIT SINGLE FAMILY 0 TNO FAMILY O TOWNHOME O YES �
TY FIMPROVEMENT EARLY RELEASE
NEW STRUCTURE O REMODEL O ATTACHED GARAGE O ACCESSORY 9UILDING
O ADDTf[ON-q Room/s O Porch q Deck q &15EMENT FINISH O DETACHED GARAGE O DEMOLtTION O YES �NO-
PROJECT P�N COMMISSION/BZA/BPW DOCKEf NUMBER/5 AND/OR ESTIMATED COST SQUARE FOOTAGE
TAC DATEJS OF CONSTRUCTION, \�JO �� ���
EXCLUDING LAND � {
PDF PLANS TYPE OF FOUNDATION /� MANUFARURED SUMV PUMP PORCH
�� CD �AIL � SIAB 4B�BASEMENT-O WALK-OUT TRUSSES
� CRAWLSPACE � P0578B PI YES O NO 5 O NO S � NO
STATE OF �DR NUMBER RELE URION 7YPE OCCUPANCY CLASS
SuS!er,t ta conpliance wiLh all reg lations
INDIANA . .
SCOPE OF RELEASE (�f (`(�^`^AA'I(�I 7�/' (�[p�� /+�L� TYPE OF RELEASE
ODRTOWNHOMES O FDN Q STR O ARCH O �MECH`i5'�PLhSfNQl6►KUlli➢IOlt1Dft � ��
For$ingle Family and Two Family Dwellings this permit is valid only� mns r ion commences within 1811 d the da�of.isnance�ojthis Permit and
must be completed,having the Cer[ificare ofOccupancy issued,within IS months ofthe date oCissuanec CI I ructure Perm�ts>re tdbjec{to the 5[ace
of Indiana General Adminis[rative Rules(GAR 675 IAC 12)regarding exPiration time Games for beginning a completing construction.
1,the undersigned,agree that any constru�tion�reconsVUCtion�enlargemenq rebcation,or alteration of a s ucYUre�or any change in the use ofland nr
strunures reyuested 6y this appliulion will comply with and conform ro ali aPPlicable laws ofthe State of I �na and the°Zoning Ordinance oI'Grmd
Indiana-1993°(Z-289)and amendmen[s,adopted under authori[y of LC.36-7 et sey�General Assembly oft �i^�•�—si*rtalhAe[samenda[ory
thereto. 1(urther tertify that only kitchen�bath�and floor drains are mnnected ro the sanitary sewer. 1 further certi(r that the construcYion will mt be
or oc ied unt e te of Occupanry h been issued by the De artment o ommuni Serv' s,Carmel�In iana.
1 nt Prinlntl ame t �I .
......................................................................................... :..............................................................................................
REQLIIRED BASE INSPECTIONS * '• PERMIT FEES ` + ��µ" '
*Additional insPections may be�equired. i Filing/ Review 1 v✓ ' � Re-Review
: BaselnsPections �
: �/Lower Footing �Rough-In �I Final '!,-� r,
yy. c Cert.of Occupanry �,�1 1 Other
:�' UPPer Footing �] MeterBase p Site i .Ci , I,�1 / �
� � P.R.I.F. 1--tL(L� J�bJ
� ❑ Underslab �_Z��/y TQTAL �.���`7�• � �
/!' / �-��� ` �`�l`!" -I `�'
: � _ €
; Hevie /Releaced Uepartrnen[o(G�mmun p�Dare � ; Fee eceived DeFiaft �f fComm t�ti�r.ices f�atr
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SiPerm�sUbr iApPl'Me�lonsUtaeidentuM.PApD�intion�2009-08 Ia.iL�pderulOxl1l2W9