HomeMy WebLinkAbout 17050141 ApplicationCITY OF CARMEL / CLAY TOWNSHIP
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For New Structures, Additions, Remodels, and Accessory Structures
PERMIT # 17Q'50149
Sewer / Water Utility
Permit #
BUILDER
NAME l! — PHONE FAX
OF
M 31-I - laq ly Z (a (Do
RECORD
STREET ADDRESS CITY STATE ZIP
1 Ca m.(d r'me
E-MAIL ADDRESS
BEST METHOD OF
I t l
CONTACT F
PLUMBING
NAME
STATE OF INDIANA PLUMBINGCODE
CONTRACTOR
MISCR VZ,OCDe IZ6 5 r'
\
CENSE NUMBER❑ [RC O UPC
PROPERTY
NAME PHONE FAX
OWNER
H L17Y1 r-6 Th C3i 31 -- 0
STREET ADDRESS CITY STATE ZIP
CoC7-n / t'j O �2
PROJECT
LOT NUMBER SUBDIVISION NAME SECTION
LOCATION
41 A(3ERDEEty 3tmD rJ A
STREET ADDRESS CITY ZIP
r n
C0-1-Me 0
'TAXMt AP PrA�RjCEL UMBER
ZONING
DZONE/S ° U'
/'�
I-1-09-2_ -� _' -OLI .Oo
LOT SPLIT
SEWER'. UTILITY WATER UTILITY
SEWER/WATER fr l
/ 17
� YES � NO
UTILITIES EXCAVATO
TYPE OF
TYPE OF CONSTRUCTION
MASTER PERMIT RPLA_ N
PERMIT
5.SINGLE FAMILY CI TWO FAMILY O'TOWNHOME
[I YES 17 NO
TYPE OF IMPROVEMENT
EARLt RELEASE
❑ NEW STRUCTURE ❑ REMODEL ❑ ATTACHED GARAGE ❑ ACCESSORY BUILDING
0 ADDITION -0 Room/s El Porch O Deck BASEMENT FINISH O DETACHED GARAGE MOUTION
0 YES q NO
PROJECT
PLAN,COMMISSION / BZA / BPW DOCKET NUMBER/S AND/OR
ESTIMATED COST
SQUARE FOOTAGE
TAC DATE/S
OF CONSTRUCTION, 5 �j
�,
.
EXCLUDING LAND
GQ�
Cl V
POP PLANS
TYPE OF FOUNDATION
MANUFACTURED
SUMP P
PORCH
❑ CD O E-MAIL
0 SLAB & 0 BASEMENT -O WALK -OUT
TRUSSES
❑ CRAWLSPACE O POST &-BEAM ❑ POST&'PIER
O YES q NO
O O
OYES q NO
STATE OF
CDR NUMBER REL[AASEDATE
CONSTRUCTION TYPE
OCCUPANCY C
INDIANA
CDR
SCOPE OF RELEASE' O6Po IkpN `C w
cIZ'
EASE
W
FORTOWNHOMES
O DN O STR ❑ LEC CH P UM E) SPKL OTHERIr
F
nn v/c
For Single Family and Two Family DwellingsthisJA
/'oSW216i
must be completed having the Certificate of Occd/ii0
of Indiana General Administrative Rules (GAR 67I, the undersigned agreethat any, construction, ro� 'a rstructures requested by this application will comonfo
Indiana- 1993" (! 289) and amendments, adopted under auth7777ority o�
thereto.: I further certify that only kitchen, bath, and floor drains arc cor
used or occupied uAl a Certificate of Occupancy has been issued by the
.................s
REQUIRED BASE INSPECTIONS
* Additional inspections may be required.
Wnceswithin 180 days of the da[ of issuance of this permit and
date of issuance, Class I Structure remits
are subject to the State
I'llames For beginning and completingonstrurtion.
a r alteration - Ytrneit+re-orart change in the use of land or
a n tana-and the"Zoning Ordinance of Carmel
q, General Assembly ofthe State of Indiana, and all Arts amendatory
the sanitary sewer. 1 Further certify that the construction will not be
nt of Community Services; Carmel, Indiana.
10 f S%ca 1_�e.sm l �K16
sme Date
................................................................................................
PERMIT FEES
i Filing /Review 1, f Re -Review
E Base Inspections I D•
❑ Lower Footing?(Rough-In Final 7
g Cert. of Occupancy Other
❑ Upper Footing ❑ Meter Base ❑ Site
P.R.I.F.
❑?�-7� Co TOTAL
Reviewed / Releasxd -Department of Community Serriees Date Received- par en FCommwnty Sernces Date
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5:\PenMs\FomuUpplications\ResiAeolielVLP Applicetbn\ 009-08 last Updated 08113/2009