HomeMy WebLinkAboutTG83 - Plan Amendment°t ��9
b�{ � (�*�yjy`��
A f ��� � Sr
C
sy'`,.y j o.
��<roN �o�
.+
REVISION / PLAN A1V�NDMENT
For New Single Family or "Other" Residential type permit projects
Cit�y of Carmel; Department of Communit°y Services
Permit has been issued: Yes No. If yes, PERMIT #: �j � 0�0 � fl"' O O J 10 $
BUILDER of "p'"'�: PFiONE: Fax:
RECORD: �� ��- ��' � �- 3 7 9- O 1
STREET DRESS: CITY: STATE: ZIP:
l lv $ . Ca-r►�,,�-� ( ar• ,-�..Q � �J �-t� Io 0 3 2
BUILDER'S EMAIL ADDRESS: BEST METFiOD OF CONTAGT:
. Go�.,�, e n-, a_� (
LQCATION LOT #: IfBDMSION NAME: SECTION:
& PRO]ECT g3 - r �� �' �G • 3P`
INFO: ADDRESS OF CONSTRIlC?ION:
� o � 8 m� C'a.� n I�
NEW SQUARE FOOTAGE OR NEW ESTIMATED COST NEW FOtlNDATION TYPE: :,/�LAB � CRAWL SPACP
AREA AFFECTED BY REVISION: o�� Q� 3 QF CONSTRUCTION: �� �j � G� � � � POST & BEAM L� 6ASEMENT ( Walkout _Y _ N)
IF PLANS FOR REVISION/AMENDMENT ARE PART OF THE MASTER PERMIT PROGRAM; NAME OF MODEL AND REFERENCE #/ID OF
PLAN SPECIPICATIONS FOR THIS WORK:
� � • • � � �a��� A�...: � ' r � �. ��_..' �..L
/ � /
S / ,. � ..� • � /_.�
NEW DES�GNAlION OF AREA �F WORK SOUARE FDOTAGE:
BASEMENT 1� Floor 2" Floor 3 Floor Front Rear Porch Total Sq. Ft. TOTAL
(Finished and Porch or of Garages
Unfinished Sunroom
N� ��t'? >,a3 � N%�► l�� g 3 �f�o a2, �a�
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences
within i80 days of the date of issuance of the building permit, and must be completed (Cettificate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits are subject to the Generai Administrative Rules of the State of Indi�n� (See 675 IAC 12) regarding expiration
time frames for begintting and completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use oE land or
structures requested by this application �vill comply �vith, and conform to, all applicable laws of the State af Indiana, and the "Carmel Unified Development
Ordinance (Z-62S-17) and amendments, adopted under authority oE I.C. 36-7 et seq, General Assembly oE the State of indiana, and all Acts amendatory
thereto. I also certify that only kitchen, bath, and floor drains are connected to the sanitary se«�er. I further certify, under the penalties of Perjury (Indiana
Code 35-44-2-i) that all of the information I ha�e provided in this Application and other documentation is true and accurate to the bcst of my
knowledge and belief, and that I have not knowingty or intentionally provided or omitted any infortnation that would tend to lude, obscure, or
otherwise mislead the Dept. of Community Services regarding the truth of the matters addressed. I also agree that the constructian will not be used
or occupied until a C ti�cate afOccupxncyhas been issued by the Department of Community Services, Carmel, Indiana.
2czwL.a� f-%tc�c.,5 � �(o a o
Signature of Owner ar Authorized Agent Print Date
OFFICE USE ONLY:************************************************************�********�**
NEW INSPECTIONS REQUIRED:
Upper Footing Lower Footing Under Slab
Rough In Meter Base Final Site
Reviewed/Approved: Dept. of Community Services (Date)
S:Permits/Fomis/Plan Amend Residential
PLAN AMENDMENT/REVISION FEE:
ADDITIflNAL SQUARE FOOTAGE:
NEW INSPECTIONS REQUIRED:
(If additional inspections other than what atready remaEn on the exissting permit are required.)
TOTAL:
Fee Reoelved by: Date