HomeMy WebLinkAbout 04030220 ApplicationCarmel/Clay � 0 o6,)- -
Township Application for Permit No.
Hold #: Improvement Location Permit Date
Roll File ;
This permit is valid only if construction is started within 180 days of the date of issuance for residential conLc 'on; and for commercial projects, within one (1)
year of the date of issuance of the State Commercial Design Release. All rnnstnirtinn must he. cmmnleted (r/n iscnedl within 7 venm of the iccm,nnre Aare
NAME
PHONE
FAX
BUILDER
LACES 14 011ES
3 6 3 _
STREET
CITY
STATE
ZIP
106.50 T
a :
zlU
TENANT NAME
(If applicable)
NAME
PHONE
FAX
OWNER
EE; ?
.37' 73CO
e,317),3q7-7319P
STREET
CITY
STATE
ZIP
I F CG
Y` ( SLL INbIANIAEC115
IA!
41& a 7
LOT SUBDIVISION
SECTION
LOCATION
`LADDRESS OF CONSTRUCTION
FaieaukaNE
l rrl 1,- iz
/
(j 4 f 1
1.5711
A. TYPEXF CONSTRUCTION Do plans inclu a porch?
1. 9 Single Family ❑ Yes UNo
2. ❑ Two Family
3. ❑ Multi -Family Type of Foundation
4. ❑ Commercial / Industrial ❑/Xrawlspace
5. ❑ OTHER Gr Basement
(Specify) ❑ Slab
B. SEWED:
1. p' Public (Name of system C f f M F L )
2. ❑ Private (County permit # )
C. WATER:
1. [Z Public (Name of system L A k m E i )
2. ❑ Private (County permit # )
D. ZONING: S -1
TYPE1. Nt
2. ❑
A itio ori—'P—rcFir Room
3. ❑
RFtachkdR
_ I�srtttg'
5. ❑
De
Ii�-
6. ❑
Ac
7. ❑
Garn
tAmiche f
G. Lot Split u U YF._— -=--�-
H. Flood Zones YES NO
I. Sump Pump O
J. Manufactured Trusses S NO
K. Plumbing Contractor RAU-1 E SM r r N
E. ESTIMATED COST OI,CONSTRUCTION IRC Plumbing Code: ❑ lumber's
(Excluding Land Value) Qyq 000,QQ Indiana Plumbing Code: License #: (bi 7T71
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, AMOs t eture, or any chat�e;iA.#ltp,>p�fbar� or structures
requested by this application will comply with, and conform to, all applicable laws of th9ghdPg Affir n'a, ind 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 Sf le74Indiana )I�aand allActs, mend thereto. I further
certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I furt?yPFMf f tl4e. at�ructiult wtilln be used or occupied until a
Certificate of Occupancy has been issued by the Department of Community Services, Carmel, Ia ftW EL i CLAY j UV1ti ' �+
d2w
�.
Signature of Owner or Author Agent
� Ica, �.ZesLNa-ANI;nI 4317 a9S-71Q(J
(Print) (Phone Number)
E-Maild b, Rbs1)&;qL1 DREES aIF-S. COM
Pl;w9ed/Appro
et #'s; TAC Date(s)
_.
-Dept. of Community Services
INSPR40143M NEEDED:
E�)Under Slab4Rough-In" Meter BaseSite
C/O z a
Sq. Ft.lFiling
RVid
Fees:
.
Base Inspections:
. 0
Cert. of Occupancy:
P.R.I.F.:
0 0
Jd 1 d U
TOTAL:.t
/ I � JJ /1 A
Fee Received by S:Pennits/Forms/ILP5-02