HomeMy WebLinkAbout14070112 Application 1\
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� �� CITY OF CARMEL / CLAY TOWNSHIP IT # lyo7 oU�— _
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION ^ Sewer / Water Utility
v eyo�o rrr
� Moux�� � For.New Structures,Additions,Remodels,and Accessory Structures Permit$�
BUILDER NAME PHO E FAX
oF NU�'Z .� � l�o.� 3��� 8/9'Z6;13 �3, �� 8r9 - a6S�
RECORD STREEf ADDRE55 / CITY STATE ZIP
,36fS �ra.� !�?y ,�' ,��e. �/./S �Z4(?
E-MAIL ADDRESS �/ ��� ��� /// BEST MEfHOD OF
. ClO✓/ �I/G�C . eO N7 CONTACf ���j'�C 1 I
PLUMBING NAME / STA7EOFINDIANA PLUMBINGCODE
CONTRACTOR �fl [7ra LICENSENUMBER ❑ [RC O UPC
PROPERTY NAME PHON FAX
OWNER ��i? / on r�u� 3�- �i�'--a� 3 �3i���i9 a� s�
STREETADDRE55 CITY STA7E ZIP
3(,�s %-,�,- (,t�c .S� r�r. .Z��!'/1 2,✓ 4�6a�
PR07ECT �OT NUMeER UBDIVISION NAME SECfION
LOCATION �� �7e �d e �ie Ge � - ec l
STREET ADORE55 . CITY STATE ZIP
S,� ' /v�%9 T�� ;•f G�- �crn+cl
7AX MAP PARCEL NUMBER ��ZONING OOD ZONE 5
- 0 -- —Q � C�/1ShceJ�//
LOTSPLIf SEWERUTILITY 'WA7ER�U �SEW ATER
.0 YES � NO Q���� /7 _�� � EXCAVATOR . �� L�ff�0��
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.TYPE OF TyPEOFCONSTRUCfION AS ERMIT ', FLOORPLAN
PERMIT 5[NGLE FAMILY � TWO FAMILY O TOWNHOME � Y 5 �NO �/e-(-�-�Jpr/ S �(Q.���
TYPEOFIMPROVEMENT EARLY RELEASE
D}�NEVJ S�RUCTURE By ED GARAGE O ACCESSORV BUILDING �/
�O ADD[TION-O Room/5 �Porch �Deck O BASEMENT FINISH O DETACHED GARAGE. q DEMOL[TION O YES p��NO
PRO�ECT �P�N COMMISSION/BZA/BPW�DOCKET NUMBER/S AND/OR ESTIMATED�COST SQUARE FOOTAGE �
TAC DATE/S OPCONSTRUCTION, /
� .EXCWDING'LAND �O� OO� �b���
PDP�PLANS TYPEOFFOUNDATION MANUFAGTURED SUMPPUMP PORCH
❑ CD � E-MAIL � SLAB � BASEMENT-O WALK-OUT TRUSSES .
� q CRAWLSPACE POST&BFAM �0 POST&P[ER� YES O NO YES O NO �L YES ❑ NO
STATEOF CDRNUMBER • RELEASEDA7E' CONSTRUC7ION7YPE OCCUPANCYCCASS
INDIANA N ��f
'CDR� SCOPE OF RELEASE TYPE OF RELEASE
FORTOWNHOMES ❑ FDN � STR 0 ARCH � ELEC O MECH O PLUM � SPKLR ❑ OTHER
For Singie�Eamily and'Pwo Family Dwellings ffiis permit is valid only if construction mmmences within 180 days o([he date oPissuance ofthis permit and
must be completed,having the Certificate of Occupanry issued,within 18 months ofthe date of issuance. Class 1 Structure Permits are subje�Y to the Stare
of Indiana�General Adminiscrative Rules(GAA 675 IAC 12)regarding expiracion time Games Coe beginning and mmpletinp construction.
I�lhe undersi�ned�agree that any construction�rcconstruction,enlargement;relocation�or alteration oEa structure�or any clun�c in the usepfland or
structures requested�6y t6is appliwtion will comply with and mnforin to all applicable lawsblthe State ollndiana and the°Zoning brdinance oFCarmel
Indiana-1993"(Z289)and�arocvdments�adoPled undcr authority oGLC.36-0 et sey,Ceneral Assem6lyAf thc State of Indiana�and a11�AcYS amendatory �
thcreto. 1 fuithet certify that only kitchen:6ath,ind tluor drains are connectedto the sanitary:sewen��1 fuiKtier certify that the construcfion will not be
usedy uccu ied il a C rtifipte o(Ottupaney has been issued 6y the DePartment of Co�mmu,ny ro Seivices�Carmel,Indiana.
[:7S' G�i�c/y /A.ruh�.. ''7-[7-ZO r�
SignaW ne orAUNOrBedAgenf Printed�Na e Uate
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REQLIIRED BASE INSPECTIONS * � PERMIT FEES
*Additional insPections may bcrequircd: : Filing�J$eview � I � �� Re-Revieav
� � : Base IusPections � � - �
�I;ower Footing �Rough-In inal �3 �
,� : Cert.of Occupancy Other
�Upper Footing eter Base ite � � �(}
' P.R.LF.
�❑�Underslab
TOTA � � - y •
: �) � ����' : � _ � � `�i :
; Revie�ved/Released—Deparhnent of Commumty Sernces Date , Fe eceneJ .D anment uf Community Services Date ,
�ti......................................................................................i �.... ....�.:..:1.-.:..:........................................................................� .
SiPeemIls�FOrmsV.pplicaiw�xVtesiden�ul�ILP Appticaiion�2009:08 tast UpWed 08/t312009