HomeMy WebLinkAbout07070083 Revision Info. r.'ApL - I
REVISION / PLAN AMENDMENT or ADDENDUM to STATE RELEASE
For Commercial, Institutional, Industrial, or Multi-Family Projects
City of Carmel; Department of Community Services
Yes No
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PERMIT #: !? ! 0 7 Q ??3
If yes
een
Permit has ssue
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BUILDER of NAM-' PHONE: FAX:
RECORD: G;?;n{ GcAecal Co.b+o. (an) 632-33s5, 31 1)
STREET ADDRESS: C:TY: STATE: ZIP:
Lcl< Sf -yb o Is 2A, y6 Lt8
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CCNMACT:
LOCATION PRO]ECT NAME: LOT a and SUB i E f pI
PROJECT u l tl ro:awat? l3 ?? ,
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INFO: ADDRESS
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y AUG 2 7 2007
6x
% PAL.l o
NEW SQUARE FOOTAGE OR ?j>?f
y/J NEW ESTIMATED COST
T
C
ION NEW FOU ON TYPE: SLAB D WL SPACE
0 POST _Y _ N )
AREA AFFECTED BY RE VISION: f :
OF CONS
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T
STATE COMMERCIAL DATE OF AMENDED !EASE: NEW SCOPE(S) OF 0 FDN C STIR C ARCH (VMECH 9P PLUM
DESIGN RELEASE :: "
SPKLR OTHER(S):
O
3
ELEC o
RELEASE: &5
S of Floors: ElevatorlLift:. 0 YES 4 NO BLDG. CONSTRUCTION TYPE: / OCCUPANCY CLASSIFICATION:
DESCRIPTION OF AMENDMENT/REVISION,
AMr.voe-C 5 MR.Iv*w 4A- AND/OR STATE RELEASE ADDENDUM/UPDATE INFORMATION:
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SLC10C: to ComnijancFl with all rPn.•:.. .•
Of State and Local Cods.
INDIA IA
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. -
[ the undersiened, agree that nay construction, reconstruction, culargeramr, relocation, or alteration of a structure, or any change in the use of lm&or
structures requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the 'Zoning Ordinance of Carmel
-
Indiana -1993" (Z-2S9) and amendments, adopted under authority of LC. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thatta. 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 1 have not knowingly or intentionally provided or omitted any information that would tend to hide, obscure, of
_ otherwise mislead the Dept. of Community Services regarding the truth of the matters addressed. I a so agree that the construction will not be used
or occupied until l al Cerrdfica`re ofOccupancyhas been issued by the Department of Community Services, Carmel, Indiana.
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Signere OfOwner or uthorized Agent Print - Date
OFFICE USE ONLY: *****************************************? *e 1?IW1**********x**k******
NEW INSPECTIONS REQUIRED:
Upper Footing Lower Footing Under Slab
Rough In Meter Base Final Site
Reviewe Approved: Dept. of Community Services (Date)
S:PerrWW nWPlan Am" rmlmadal, Ind, Inst. Muld
PLAN
ADDITIONAL
I a?7??e
NEW INSPECTIONS REQUIRED: _
(If additional InspecJons other than what already remain
TOTAL:
Fee Received by:
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