HomeMy WebLinkAbout14070135 Application � , ..
� , ; �` CITY OF CARMEL / CLAY TOWNSHIP PERMIT # �4D�013.�
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION Sewer / Water Utility
' �„oi�pa; For'New Structures,Additions,Remodels,an[l Accessory�Structures Permit$�u��7 o I��
BUILDER NAME PHONE FAX
oF GUr M , � S 3 !�-g ! -31.015 �J �'
RECORD �TREETADDRE55 CITY STA7E ZIP
i '182�4 Nloen c�w � 6�� No�61��s�v�l�.v, . 1J, � � t� (� �
E-MAILADDRESS (p/,�f r 1{ /� BE$TMEfHOD�OF / /
C U%'� � l C V 1��J ` V�(,�1 1 a L�U nA COI/TACT � f�_ 2 r�l Q .-�l0 � � M
� � J (
PLUMBING NAME � STA7EOFINDIANA. PWMBINGCODE
p� r, LICENSE NUMBER � p
CONTRACTOR �vrn� � I�,� 2 t''UM�1p fQ$� L„l � o iRC �t uac
PROPERTY 'nnrne I PHONE �( �/�/1
OWNER �C3.y F�rY1CLYZdn 3 �7" � 1�- C'�'� -rj� R
SfREETADDRE55 CITY STATE ZIP
3 3 -1,do FI��P�r l�r ; sv� lle � �N C�o
PRO]ECT LOTNUMBER SUBDIVISI�N'NAME � SERION
LOGATION d ver r a �ar W15 �
STREETADDRE55 , CI7^/ 1 STATE 2IP
I�Z (�a C���r b ro o�' br, ll�es�--r p�r� �.[J . �- 0 r
TAX MAP PARCELNUMBER ZONING FLOOD 20NE/S
17 -��I - I�l0O-c73�04b.oco 5-� /l�d�� X-un5hc�c�p�
LOTSPLIT SEWERUTILIfY x��D WATERUTILI7Y SEWER/WATER I
0 YES �NO '��-yn�, . U7IlITIES El(CAVATOR C U�{��jG�� ��C,1 �4��0 4�,
TYPE OF TYPE OF CONSTRUC7ION MASTER PERMI7 FLOORPLqN
PERMIT �,1 SINGLE FAMILY O PNO FAMCLY O TOWNHOME � YES Q NO
TYPEOFIMPROVEMEN7 EARLY RELEASE
� NEW STRUCTURE pCI CApC �r� I ATTACHED GAR4GE O ACCESSORY BUILDING
�O ADDi170N-O Room/s q PdiF.h�-6!DatlkD,_pl,��ryi�T��ETACHED GARAGE 0 DEMOLITION p YES O NO
PRO]ECT PaN COMMISSION/BZA/BP ^ �b�l E�IMATED COST' SQUARE FOOTAGE
TACDATE/5 of5tateandLocalCodes OFCONSTRUCTION, (p.�Q 0� . .��,��q
LUDING LAND 1 (
VDF PIANS TYPE OF FOUNDATION � UFARURED SUMP PUMP PORCH '�
O CD �1 E-MA7l � CR4WLSPACE � Po����o'�� CL�Y TON! 9H4�ESO YES J& NO �{1 YES � NO �YES O NO
STATEOF CDRNUMBER kELEASEDATE CORSTRURIONTYPE OCCUPANCYCLASS
INDIANA ,�C- i'. �'r li `i''i' 1;
CDR SCOPE OFRELEASE P OF LE �' � I
FORTON�NHOMES O FDN 0 STR � ARCH O ELEC. OMECH 0 PLUM � SPKLR O OTHER � il
L r i
ForSingle Family and Two FamilY Dwellings this Permit is valid only if consvuction eommences avithin 1R0 ys of the date of issuance ofthis P rmit and
�mustbecompleted�havingtheCertificatebfOccuPancyissved�wiihinlSmontheoSthedateoFissuenee. slStructurePCrmitsaresubjectt theState
of Indiana Generel Administrative Rules(GAIi 675�IAC 12)rega*ding eapiration[ime frames for beKinninx �cm axntmctiort-
1�the undersigned,agree that any consVUCtion�rcmnstruction�ml5rgement�relocaTioq or aiteration ofa structu�c�or any change in the use ofland or
atruc[ures reyuested�by this aPPlication will comply with and conform�to all aPPlicable lawa oFthe State oflndiana and the"'Loning f�)rdinanee of Carmel
Indiana-1993"(Z-289)and amindments,adopted under authurity of�1.Q36-7 et�sey�General Assembly oftfie State o(Indiana�and all Acis amendatory
[hereto. I Curther ceitiLy.that only,kitchen�ba[h�and lloor drains are connected fo the sanitary sewer. Pfurthermr[ify t6at the construction will not be
used or oDccuPie,d1 u,ntil a Cert�if/ie,ate�of Occupancy has been issued by.the DePartment o(Communi[/y�Services,Carmel�Indiana.
�fl,t�.f.'m. �.t�l:li� �'.Ur"t l� . I�UY"�S 7 'L..( l
Signature o/Owner or Rutharimd AgBnt Printed Name Date.
�......................................................................................t ,..............................................................................................�
REQLIIRED BASE INSPECTIONS * � ` PERMIT FEES
*Additional inspections may be required. : Filing / Review � � � Re-Review
: BaselnsPections ; 7G 3,�
✓
'-�/t.ower Footing �Rough-In �j Final ; CerL ofOceupancy ����� pther
: �/UPper Footing �/Meter Base �;Site _I �/J;-7
'• P.R.I.F. � O-T !�
: �Underslab ���
TOTAL c��l �
�ZS-� '•�✓C'i�l-Yl ��.�-�� :
; Ra'view �/'Released DepartmentolCommunityScrvices Dare � �FeeR 'eived-D rtm� tofCommunityServicei U te ;
�......................................................................................i i.....................:....:.........:.........................................................��
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