HomeMy WebLinkAbout14070120 Application �tV���
�• .; . CITY OF CARMEL / GLAY TOWNS�I'IP PERMIT # I Na7ol�
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION Sewer /�Water Utility
� -�NOUx� �. For New Structures�.Addilions,Remodels,and Accessory,$tructures PCrmit�$
BUILDER "aMe PHONE FAX
oF �Q�k a�c� B��`ld�"n 5 .5�5'-/7/8" 5 (� 9-Co S�o/
RECORD S7REET ADDRE55 \ CITY �� / STATE '/ZIP
�9 � � �CL/'1 ��t�i n C � OQ U �CG..r'M�'e_I /V 7�s CJ �2
�E-MAIL ADDRESS � eEST METHOD OF
CONTACT...'2 t..'1 —� I L'1�S��r
J I � J
PLUMBING NpME SfATE OF IND2ANA PLUMBING CODE
CONTRACTOR LICENSENUMBER o �ac o uvc
P,ROPERTY NAME PHONE FA%
OWNER e .Schu �f2 $�fy-338� 8"/9-30/0
STREET pDDRE55 CITY STATE IIP
3Ql L-ucanr-n sf� �a✓n�e./ /v �/Co�33
PROJECT �OT NU ER SUBDIV75ION NAME SECfION
LOCATION � � S ri
SfREETADD ESS ITY STATE 2IP
�� G( cu.11�l i�. I " ' ' ��l/
TAX.MAP VARCEL NUMBER� � �� � "Y �,�I ��I �/ FLOOD ZONE/S ,
/lo -/s�`Olo-oa -(9 0/� oo �
LOTSPLIf SEWERUTILITY WATER� I � G ���� U7���J SAEXCAVATOR
❑ YES NO
TYPEOF TYPEOFCONSTRUCTION B MASTE PERMIT FLOORPLAN
PERMIT SINGLEfAMILY O TWO'FAMIL Y _—_--- YES � NO
TYPEbFIMPROVEMENT �EARLY RELEASE
� NEVJ STRUCTURE 0 REMODEL � ATTAGHED GAR4GE `�, ACCESSORY BUILDING
� � ADDITION-O Room/s �Porcli �Deck � BASEMENT FW[SH O DEfACHED GARAGE � DEMOLITION q YES ,�{.NO
PROJECT PaN COMMISSION/BZA/BPW DOCKET NUMBER/5 AND/OR ES7IMATED C05T SQUARE FOOTAGE
� TAC DA7E/S OF CONS7RUCfION, .�[OO� /n^
� � EXCLUDING�LAND / 7p�..
.PDFPUINS TYPE OFFOUNDA7ION MANUFACTURED SUMPPUMP PORCH
O CD O E-MA[L � SLAB BASEMENT-�WALK-OUT TRUSSES
❑ CRA4VtSPACE POST&BEAM O POS7&P[ER q YES `G�Q�NO q YES � NO q YES �QQ NO
STATE OF �DR NUMBER RELEASE DA7E CON5TRUCTION TYPE OCCUPANCY CLA55
INDIANA
CDR SCOPE OF RELEASE - � TYPE OF RELEASE
FOR�70WNHOMES O FDN O S7R � ARCH � ELEC O MECISLI�JeVtQB�jOf�l�1����'iI II P,�ERiofls
fS
For Single Pamily and�Two Family Dwellings[his Permit is v i7r-a y�y����y���o ,','��{p��', `,(l7�V�Y�,p�)��jMI�days of che da[e ofissuance of this Permit and
must be comPleted,having the Cer[ificate of Occupanry.is � i�+l'b�HhtHS�f��at�of issuaneo Class I Structure Pertnits are su6ject to the State
oflndianaGeneralAdministrativeRWes(GAR6751AC12)rega�dingexPirati�� esforbeginningandcomrletingmnsvuction.
ly the undersigned�agree th5t any construction�reconstruction�enlargement�relocation�or al[erafion of 5 svucture�or any chan�.e in the use o(land ur
�structures requestcd 6y this application will comply with and conPorm�to all zPPlica6le laws oLthe SGte o(Indiana and the°Loning brdinanm of Carmel
Indiana-1993"(Z289)and amendments,adoPted under authority of I.C.36-7 et sey�Generel'Assembly oft6c State of Indiana�and all Ac[s amendatory
thereto. 1 further cer[ify that only�kifchen�bath�and�loor drains are connec[ed�to the saniGry sewer: 1 further ce�tify that the construction will not be
used or occuP� d until e Ce 'fi f Occup ncy ae 6cen iesved 6y the Department ofCommuvity Servicca�Grmel}Indiana.
� l�n �GLiu��Z 7/a
'Signahre o Owner or Autfiorizetl Agent Printetl Name Date
�..........................:..........................:................................� ;.............................................................................................�
REQLIIRED BASE INSPECTIONS * � PERIVIIT FEES f�
*'Additional�_insPectibns�mayberequired. : Filing�/Rediew �w� � � Re-Revicw
: Baselnspections (�5.50 �
i ❑ Lower Footing ❑ Rough-In ❑ Final ��
� C Cert.of OccuPxncy �,p � J , ,� Other
: ❑ Uppei�Footing ❑ MeterBase �Site ��
� P.R.I.F.
'• ❑ qnde 31ab TOTAL ��vl• � �
: _ -/ jU�-�' 7- ��-i�
; R viewed/Relea d D ment of Commum Sernces Da e F e Rec� p mento(Cam w ty Sernceti Da�e j
v................�............p.d.n....................}...... .......r �......... ... . ... . ...................................................................�
S:�PertndsV�orms\Applica�ions�Residm�ialW.P Application¢fA19-08 Isvi Updated OR/132W9