HomeMy WebLinkAbout 04030235 ApplicationCarm1W
Township
Dc;1Z 3,
Application for r Permit No._
Date
Hold #: improvement LOCIItion Per)ytlt Roll File % "I ; ,-
This permit is valid only if construction is started within 180 days of the date of issuance for residential construction; and for commerciarprojects, within one (1)
year of the date of issuance of the State Commercial Design Release. All construction must be completed (c/o issued) within 2 years of the issuance date.
BUILDER
E
u ��� u (i1 �•
PHONE
O� Cj dl'st->�' X c� 1 �'
FAX
-1 a-'
STREET
tsck4
v dL vi
CITY
)+ 30 Cyr mA
STATE ZIP
TENANT NAME
If applicable)
OWNER
NAME
U `��
�N'1`�SSTREET
PHONE
U)
CITY
"FJ
ZIP
LOCATION
LOT SUBDIVISION
L 3 ��tC��
ADDRESS OF CONSTRUCTION
Y1:3
47
A. T OF CONSTRUCTION Do plans include a porch?
1. Single Family Ayes ❑ No
2. ❑ Two Family
3. ❑ Multi -Family
T pe of Fo
4. ❑ Commercial / Industrial
$5 Cra`
5. ❑ OTHER
E, Bas4
(Specify)
❑ Slab
B. SEV i .
1. Public (Name of systerk t',M
2. ❑ Private (County permit # )
C. WATER: nn
1. 1
A, Public (Name of systems uYk V�-iP (�
2. ❑ Private (County permit # )
D. ZONING: "
E. ESTIMATED COST O CONS,TRUCTION
(Excluding Land Value) I J ` C
`-fov -
f jc, u
F. TYPPjOF IMPROVEMENT
1. New Structure
2. ❑ Addition: Pdre_h- Roo
3. ❑ Remodel j2Qomrperdi Tenant Space
4. ❑ Foundation ont - , Y �y
5. ❑ Demolitio -n
6. ❑ Accessoryyii Cn
7. ❑ Gara V eRcQl;� Attached
Ain
-
r- - 7
Lot Split �g` � NO
Flood Zones $E NO
Sump Pump ? N
Manufactured Trusses" 63 NO
K. Plumbing
IRC Plumbing Code: L
Indiana Plumbing Code:
Zk I
0000- pi
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structurP, or any c}iange tip the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the 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 are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a
Certificate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
INSPECTIONS NEEDED:
Signature of Owner or Authorized Agent tfootin nder Slab oug -I et r Base
(Print) (Phone Number)
E-Mail: !1►'4ik
Plan CCoom/mission/BZABPW Docket #'s• TAC Date(s)
W
Reviewed/Approved: Dept. of Community Services
Site Final /O / /
�— Sq. F (Q
Filing Fees: 3Z
Base Inspections: G C,(-
Cert. of Occupancy: - S GCS
P.R.I.F.: G G
TOTAL:
A<, ro
F e e S:Permits/Forms/ILP5-02