HomeMy WebLinkAbout05100069-Revision
REVISION / PLAN AMENDMENT
For New Single Family or "Other" Residential type permit projects
City of Carmel; Department of Community Services
Permit has been issued: ~ Ves
No.
If yes, PERMIT #: Q)'5 \ (i)(l)'Tl<oq
. BUILDER of
RECORD:
NAME:
t::1>~..~
STREff ADDRESS:
PHONE:
,--_--!~_.~;_.;7~::-;T-r';::::< \
i r-, r;=o r(.~c 1'-" I' 0'1 ,,- I' ",
"r'\ . \ IJ ):::... J \:. l::.:::J ,\ \ \\
BUILDER'S EMAIL ADDRESS:
~..
~
SLAB 0 CRAWL SPACE
NT (Walkout_Y _ N)
CITY:
,\\ 1\1
LV:J~\
LOCATION
& PROJECT
INFO:
LOT #;
SUBDIVISION NAME:
...
ADDRESS OF CONSTRUCTION;
\~
NEW SQUARE FOOTAGE OR
AREA AFFECTED BY REVISION:
NEW ESTIMATED COST
Of CONSTRUCTION:
IF PLANS FOR REVISION/ AMENDMENT ARE PART OF THE MASTER PER
PLAN SPECIFICATIONS FOR THIS WORK:
FERENCE # /ID OF
DESCRIPTION OF REVISION:
did. voa;, Q....~G9"'=. -\.---
g,,,a
'PI""" \"''''''
'Q..1t.""''-\Il"'lt.... .
":\'0.'1'" ",S; w-.o\:: C\~
"'CL\l,,,Us,",. ~..l",......-n:k rGt....\.~~~('~~e....
,","'M ~ta .,O"".aN~~!1"'" .
REL liance With a
. eiJ: ~n rnmD . bg,..(~
NEW DESIGNATION OF AREA OF WORK SOB~'iiE FOl!I1>A~E:~~MCl ~N\Tv SERVICE51P
. CUIVI NSH
BASEMENT 1" Floor 2nd FI Ft' Rear Porch
(Finished and crN IN \AIIl&ch or
Unfinished Sunroom
..........,....
"'""
.~
'no.-\',,"-
0'" 1"'CU"~,L"'t.'n.
Total Sq. Ft.
of Garages
TOTAL
For Single Family and Two 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.
L the undersil!ned, agree that any c'onstrtlction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or
structures requested by this application vvill 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 also certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify, under the penalties of Perjury (Indiana
Code 35,44~ 2,1) 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 .slead the D of Community Services regarding the truth of the matters addressed. I also agree that the construction will not be used
til a C tific te of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
Sig
Print
Mn._ ~~....r\....
~lelfZl5
Date '
OFFICE USE ONLY: *********************~*****~~*****************************************
NEW INSPECTIONS REQUIRED: 0./1 ~~rlAMENDMENT/REVISION FEE:
Upper Footing
Lower Footing Under Slab
Roug h In
Meter Base
Final
Site
ADDIllONAL SQUARE FOOTAGE:
NEW INSPECTIONS REQUIRED:
(If additional inspections other than what already remain on the existing permit are required.)
11~
Reviewed/Approved: Dept of Community Services (Date)
$:Permits/Forms/Plan Amend Residential
TOTAL:
Fee Received by;
Date