HomeMy WebLinkAbout19070072 Applicationa
CITY OF CARMEL / CLAY TOWNSHIP
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
ya�yyt.. i For New Structures, Additions, Remodels, and Accessory Structures
PERMIT # 1(4 0_7
Sewer / Water Utility
Permit #
BUILDER
NAME PHONE FAX
OF
Decks 5y 3/7-7�70-6527 317-770-364-5
RECORD
STREETADDRESS Nb9t St2CtE STATE ZIP
/ z o Pr.✓E 7 4---�- n/ 9�M� r^v
E-MAIL ADDRESS
BEST METHOD OF
S,IL/FQ &F co,"
CONTACT e/W g=4
PLUMBING
NAME
STATEOFINDTANA
PLUMBING CODE
CONTRACTOR
LICENSE NUMBER
Q IRC Q UPC
PROPERTY
NAME PHONE FAX
OWNER
ST�'d%ig+✓ MC=712YFLCc� .3/7- (09`/-zVy'8
STREET ADDRESS CITY STATE ZIP
115-02 /IMtkz-/✓Z.2C PKWY elvrz e+ _ _zw Al. {oo3z
PROJECT
LOT NUMBER SUBDIVISION NAME SECTION
LOCATION
4,2- Gals Farzo pftRK
STREET ADDRESS CITY STATE ZIP
//5-07- 1L1ckENZ=EF PL<WY 6Af2M4G�L- _2:7W 'f/ 032
TAX MAP PARCEL NUMBER
ZONING
FLOOD ZONE/S
LOT SPLIT
SEWER UTILITY WATER UTILITY
SEWER/WATER
UTILITIES EXCAVATOR
❑ YES ❑ NO
TYPE OF
TYPE OF CONSTRUCTION
MASTER PERMIT FLOORPLAN
PERMIT
SINGLE FAMILY O TWO FAMILY Q TOWNHOME
O YES Q NO
TYPE OF IMPROVEMENT
EARLY RELEASE
Q NEW STRUCTURE D REMODEL O ATTACHED GARAGE Q ACCESSORY BUILDING
ADDITION - Q Room/s Q Porch )?Deck Q BASEMENT FINISH O DETACHED GARAGE Q DEMOLITION
D YES D NO
PROJECT
PLAN COMMISSION / BZA / BPW DOCKET NUMBER/S AND/OR
ESTIMATED COST
SQUARE FOOTAGE
TAC DATE/S
OF CONSTRUCTION, 'J
EXCLUDING LAND
PDF PLANS
TYPE OF FOUNDATION
MANUFACTURED
SUMPPUMP
PORCH
D CD Q E-MAIL
Q SLAB - IJ BASEMENT - Q WALK -OUT
TRUSSES
D CRAWLSPACE J>I POST & BEAM Q POST & PIER
Q YES Q NO
O YES Q NO
Q YES D NO
STATE OF
CDR NUMBER RELEASE DATE
CONSTRUCTION TYPE
OCCUPANCY CLASS
INDIANA
CDR
SCOPE OF RELEASE
TYPE OF RELEASE
FOR TOWNHOMES
Q FDN O STR Q ARCH Q ELEC Q MECH O PLUM Q SPKLR Q OTHER
For Single Family and Two Family Dwellings this permit is valid only if construction commences within 180 days of the date of issuance of this permit and
must be completed, having the Certificate of Occupancy issued, within 18 months of the date of issuance. Class I Structure Permits are subject to the State
of Indiana General Administrative Rules (GAR 675 IAC 12) regarding expiration time frames for beginning and completing construction,
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in 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 hrdinance of Carmel
Indiana - 1993^ (2289) and amendments, adopted under authority of I.C. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. 1 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.
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73 �� E-
oaCtEc 7x 9 9
sig actureofzw or Agent Printed Name wee
......................................................................................
REQUIRED BASE INSPECTIONS
* Additional inspections may be required.
❑ Lower Footing ❑ Rough -In ❑ Final
❑ Upper Footing ❑ Meter Base ❑ Site
❑ Underslab _
Reviewed/Released — Department of Community Services Date
................... .................................................... ..............
f
S:lremikslPo=m Appl atbnsUtesldentiaM Applia iont2009-08
..................... I........
PERMIT FEES
Filing / Review Re -Review
Base Inspections
i Cert. of Occupancy Other
P.R.I.F.
TOTAL
Pee Received Department of Community Servleea - Date
Uvt Updated 08/1312009