HomeMy WebLinkAboutGLUSHIK L212 LOT PLAN AMENDMENT5'o cnxa
OREVISION / PLAN AMENDMENT
; For New Single Family or "Other" Residential type permit projects
00 City of Carmel; Department of Community Services
Permit has been issued: Yes No.
If yes, PERMIT #: 19010 1
Z 1
BUILDER of
NAME:
�Bon..wD,N
PHONE:
FAX:
RECORD:
GQ AS oce
ail.53
.ZS'T5
STREET ADDRESS:
CITY:
STATE:
ZIP:
62530 F 75+1 S IS10
INDP
/N
Y192<50
BUILDER'S EMAIL ADDRESS:
BEST
METHOD OF CONTACT:
nhvt'tTJrc� ® racltsa-,, net
LOCATION
LOT #: SUBDIVISION NAME:
SECTION:
& PROJECT
212 V i )1R e off' We64
INFO:
ADDRESS OF CONSTRUCTION:
17 (e ISAQ JFA I N
NEW SQUARE FOOTAGE OR
NEW ESTIMATED COST
NEW FOUNDATION TYPE:
O SLAB O CRAWL SPACE
AREA AFFECTED BY REVISION:
OF CONSTRUCTION:
o POST & BEAM O BASEMENT ( Walkout _Y _ N )
IF PLANS FOR REVISION/AMENDMENT ARE PART OF THE MASTER PERMIT
PROGRAM;
NAME OF MODEL AND
REFERENCE #/ID OF
PLAN SPECIFICATIONS FOR THIS WORK:
DESCRIPTION OF REVISION: '}�Lo'I �Tlar-) IZ¢vi5ed — M arecl laCl 5-Pee4.
NEW DESIGNATION OF AREA OF WORK SQUARE FOOTAGE:
BASEMENT
(Finished and
Unflnished)
1st Floor
2"" Floor
3`d Floor
Front
Porch
Rear Porch
or
Sunroom
Total Sq. Ft,
of Garages
TOTAL
For Single Family and'I'wo Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences
within 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 LAC 12) regarding expiration
time frames for beginning and completing construction.
1, 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 "Carmel Unified Development
Ordinance (Z-625-17) 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 also certify that only kitchen, bath, and Door drains are connected to the sanitary sewer. I further certify, under the penalties of perjury (Indiana
Code 35.44.24) that all of the information I have provided in this Application and other documentation is true and accurate to the best of my
knowledge and belief, and that I have not knowingly or intentionally provided or omitted any information that would tend to hide, obscure, or
otherwi 's ead the Dept. of Co memty Services regarding the truth of the matters addressed. I also agree that the construction will not be used
or oceuQ III a " 'cote of rpancy s been issued by the Department of Community Services, Carmel, Indiana.
MAeK (SrawD,SON 19MOA9
Signature of Owner o rthorrzed ent Print Date
OFFICE USE ONLY:**********************�*******�***************�*********�*»<*************
NEW INSPECTIONS REQUIRED:
Upper Footing Lower Footing Under Slab
Rough in Meter Base Final Site
PLAN AMENDMENT/REVISION FEE:
ADDITIONAL SQUARE FOOTAGE:
NEW INSPECTIONS REQUIRED:
([f additional inspections other than what already remain on the existing permit are required.)
TOTAL:
Reviewed/Approved; Dept. of Community Services (Date)
S:PermitsfForms/Plan Amend Residential
Fee
Date