HomeMy WebLinkAbout 0491.02 Application\vclay
p b Application for �j� Permit No.
1'#: improvement Location Permit Rooll File
FjI
his permit is valid only if construction is started within.180 days of the date of issuance for residential construction; and for commercial projects, within one (1)
year of the date of issuance of the StateCommercial Design Release. All construction must be completed to/o issued) within 2 rears of the issuance date.
BUILDER
NAME OO
J
PHONE
5ON15-Z�1j0
FAX
STREET
�vivW_mkk*1-1c(o
CITY
STATE ZIP
4 ' 3".
TENANT NAME
S
r i
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i�
(If applicable)uOy�Cl`i
1
_ I -,
M
NAE
® +fie"bf';' tnAiia;7, 11�1J1',T FA* 2002 t�' II r
QS�'rtJiy, llltfh�al/(f"':: 1
OWNER��
/%Y 4;;"
`v ; �1J
STREET
�CITY�, J ZIP
LOT
Jt/y� CPION.
LOCATION
j(/,y,r�
�pS•,U/B�DIVISION
ADDRESS OF CONSTRUCTION
2�� V-1 ✓`Wpois
,1 V V
A. TYPE Xi
CONSTRUCTION Do plans include a porch?
1. 5j0 ii Single Family �:1'es ❑ No
2. ❑ Two Family �� VV
3. ❑ Multi -Family Type of Foundation
4. ❑ Commercial / Industrial Crawlspace [)., V-1� 5. ❑ OTHER I , Basemenf`-IZ_t
(Specify) ❑ Slab
B. SEWER:
1. Public (Name of systems Ian
2. ❑ .Private (County permit # )
C. WATER:
1. 'Public (Name of system
2. ❑ Private (County permit # ')
D. ZONING: ,
E. ESTIMATED COST (
(Excluding Land Value)
F. TYKE OF IMPROVEMENT
1. New Structure
2. ❑ Addition: Porch Room
3. ❑ Remodel ❑ Commercial Tenant Space
4. ❑ Foundation. Only
5. ❑ Demolition
6. ❑ Accessory Building
7. ❑ Garage Detached Attached
J. Lot Split YES NOI,
H. Flood Zones YES NO ✓
I. Sump Pump YES NO
J. Manufactured Trusses YES NO
K. Plumbing Contractor 11k, a Jwy, 1 -(- C%
IRC'Plumbing Code: ❑ Plumber's_
Indiana Plumbing Code: ❑ License
1, the undersigned, agree that any construciion, reconstruction, enlargement, relocation, or alteration of a structure, orany change in the use of land or structures
requested bythis application will comply with, and conform to, all applicable laws ofthe State of Indiana, and the "Zoning Ordinance of Carmel Indiana- 1993"
(Z-289)and amendments, adopted under authority of I.C. 36-7,et'seq,-General Assembly of the State of Indiana, and. all Acts amendatory thereto. I further
certify that only kitchen, bath, and floor drains we connect to the ss���a//////nitaryse er. I further certify that the construction will not be used or occupied until a
Certif' to of Occupancy has been issued by the Dep ment of to Services, Carmel, Indiana.
signature orvwner or Aumonzea Agent
Ll Vau- VA (-Qn C Z x2 Zv
(Print) (Phone Number)
E-Mail:
Plan Commission/BZABPW'Docket '#'s; TAC Date(s)
Reviewed/Approved: Dept. of Community Services
INSPECTIONS NEEDED:
Footin nder Slab Rough'n Meter se
Site 'Fi/C/O J'
`7 t 'J Sq. Ft. "/�
Filing Fees:
Inspection Fees:
Cert. of Occupancy:
P.R.I.F.: aC
yS i
TOTAL: _ !1 / 13 ,</ 1 L /l
Fee Received by
S:Permits/Forms/H_P2-02