HomeMy WebLinkAbout06060199 Revision Info
REVISION / PLAN AMENDMENT
For New Single Family or "Other" Residential type permit projects
City of Carmel,. Department of Community Services
Permit has been issned: ~ Yes
No,
If yes, PERMIT #: ~. -' - - - Q)u.ITlCtlEll\~
BUILDER of
RECORD:
NAME:
E~..
STREET ADD 55:
PHONE:
FAX:
eo
CITY:
STATE:
ZIP:
BEST METHOD OF CONTACf:
LOCATION
&. PROJECT
INFO:
LOT#:
,..'
SUBDMSION NAME:
SECTION:
,~
ADDRESS OF CONSTRUCTION:
NEW SQUARE FOOTAGE OR
AREA AFFEcrED BY REVISION:
~tI. .....
IF'PLANS FORREVISIONj AMENDMENTARE'PART OF THE MASTER PERMIT PROGRAM; NAME OF MODE[ AND'REFERENCE #jID'OF
PLAN SPECIFICATIONS FOR THIS WORK:
NEW FOUNDATION TYPE: 0 SLAB 0 CRAWL SPACE
o POST & BEAM 0 BASEMENT (Walkout_Y _Nl_.
DESCRIPTION OF REVISION: n~""-_ ~ \vv. -~. "T',.--- alii:.. ~_ C'" ~411 -.A-~~fOlt..,...
'i!:...\ \o."",\" .... .--1~
NEW DESIGNATION OF AREA OF WORK SOUARE FOOTAGE:
BASEMENT 1" Floor 2"" Floor 3'" Floor Front Rear Porch, Total Sq. Ft. TOTAL
(Finished and Porch or of Ga rages ,
Unfinished) Sunroom I
~ I
C.\o\Q~
I
For Single Family and Two Family dW~~ri~~ . hf!PdJor accessory structures, this permitis valicLo~yjf'constn1ction co:nuhences .
within 180 days of th ~NI'e1J,U'i . oouJl8,tllati'lnust be completed (Certificate.ofOccupiilc"iilisued),~thin 18 months of the
issuance date. c~~e~M~bJei& 8 ~eral Administrative ~E!es.o}Jge~~~;~Jn:~iii:t~ ~9_7S I^:9 12) regarding expiration
. subiectlO 0 nd L~ . ~<t\i!sr' gandcomp'l~c?nstructi3.9!~-- \\\ \\\ '
I. the u, ndersurn~ ~gree that rD1ri~~~~, ijt6zf,' " r,elocatton~qr alt~ation~ofa structure, or any ~ ,g <; m the use of land or
structures requested ~ ~61"i@0M pli ~,an<l1>\ll! " ' applicabl~hiw, I:lt the State of Indian"'MoI the 'f?n1I\il Ordinance of Carmel
Indiana -1993" (Z.2~~ .lirien~~e d\U,\Je} .ulhorttyofLC. 36-7 et seq, G~aulssemb)y,~f tMS€lteLM-illdiana,\andiill Acts amendatory
thereto. Ialsoce . IilYii ,a" ~ainsarecoim~ctedtothesanit \r.~~~. lfuN:6certify.underth~PdalfaesofPetjury(Indiana
Code 35~44~ 2'1)~f the UU:o:rma.ti~ ~eprOvided in this Application and Q r 'urnentation is ~and-aCCiirate to\the best of my
knowledge and belief, and that I have not knowingly or intentionally provided or 0 ~ d \ \ il;tformatf5'iithat would tend to bide, obscure; or
otherwise mislead the Dept. of Community Services regarding the truth of the matt addressed. I also agree thtI.t.the'c~ctiQn will not be us-ed
oroccu . duntila Cer. cateof Occupancyhas been issued by the Department of Co unitySe' ,elifiii'cl,llidiana.
..._1-...... C~rtd. ~
1J;......2AQ\lp
Date
Sign
Print
OFFICE USE ONLY: **************************************** ********************************
NEW INSPECTIONS REQUIRED: NO ~ PLAN AMENDMENT/REVISION FEE: 0
Upper Footing Lower Footing Under Slab ADDmONAL SQUARE FOOTAGE:
Rough In Meter Base Final Site NEW INSPECTION~REQUIRED:
;:~n~~::;:;::~ln =, (:;J ~g pennllare ,eqUI,red')
CY'd..~a \VIl-serr '[-l-ch 7#~~
Reviewed/Appnlved: Dept. of Community Services (Dale)
S:Permlts/ForllWPlan Amend Residential Fee ReceIved by: Date