HomeMy WebLinkAbout12110090 Application CITY OF CARMEL / CLAY TOWNSHIP PERMIT # I a I1 o a ? 0
'/ RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION Sewer / Water Utility
xo ?. For New Structures,Additions,Remodels,and Accessory Structures ,IF(_k Permit #
BUILDER NAME PHONE FAX
OF /4/W 'v /aeur 3(9 543 - l9°6 319 ?5-5--/03 Z
RECORD STREET ADDRESS / CITY STATE ZIP
Z3 • 6- J" Str, f _ to 6- ._ /AJbVZS Al Q ZO V
E-MAIL ADDRESS �� JA4 , BEST
ACTH6// a6
CONTACT �7 �45 I
PLUMBING NAME '/a7 f STATE OF INDIANA PLUMBING CODE
CONTRACTOR f14-i-r /�'la.(�T��vr � --++`" LICENSE NUMBER -2�j . 5 7 x IRC p UPC
PROPERTY NAME {{ / PHONE ,,! FAX 7 /`
OWNER Jy4 7[ 6R ePtechfriz 319 q/4/- 'V/7
STREET 5--2m ADDRESS Oijw� ASS S CITY ` STATE ZIP 4-I g 6033
PROJECT LOT NUMBER �1�SUBDIVISION NAME ,/SECTION
LOCATION cQ/'7 6 Jig PgSS 6f/Zh�2 JAS c/4j3
STITT AQDRESS
1,/ UW"W C ( /,I t(l CITY
l�I+ /-1„STAQ U r� '4.
TAX MAP PARCEL NUMBER * ZONING r„CL Ti ' zil
s- �` /
T � -
IC�- io�aW-va a4- o��s. caoo 5 I C - .
LOT SPLIT SE R UTILITY WATER UTILITY SEWER/WATER
❑ YES )8NO !� UTILITIES EXCAVATOR NOV 3 O 2012
�t J J
TYPE OF TYP OF CONSTRUCTION MASTER PERMIT FLOORPLAN
��PERMIT FAMILY U TWO FAMILY ❑ TOWNHOME U YES ❑ NO By
TYPE OF IMPROVEMENT EARLY RELEASE
O NEW STRUCTURE ❑ REMODEL 0 ATTACHED GARAGE ❑ ACCESSORY BUILDING
O ADDITION- U Room/s 0 Porch 0 Deck XBASEMENT FINISH ❑ DETACHED GARAGE O DEMOLITION ❑ YES ❑ NO
PROJECT PLAN COMMISSION/BZA/BPW DOCKET NUMBER/S AND/OR ESTIMATED COST SQUARE FOOTAGE
TAC DATE/S EXCLUDING ULANDN� Zck f / V°rt
PDF PLANS TYPE OF FOUNDATION MANUFACTURED SUMP PUMP PORCH
❑ CD ❑ EMAIL 0 SLAB ASEMENT-0 WALK-OUT TRUSSES
❑ CRAWLSPACE e 0 POST&BEAM ❑ POST&PIER ❑ YES'(); 3) Q('YES ❑ NO ❑ YES ❑ NO
STATE OF CDR NUMBER RELEASE DATE CONSTRUCTION TYPE OCCUPANCY CLASS
INDIANA
CDR SCOPE OF RELEASE TYPE OF RELEASE
FOR TOWNHOMES ❑ FDN U STR U ARCH ❑ ELEC ❑ MECH U PLUM ❑ SPKLR ❑ OTHER _
For Single Family and Two Family Dwellings this permit is valid only if construction commences within 180 days o t • ,t ance of this permit and
must be completed,having the Certilicate of Occupancy issued,within 18 months of the date of issuance. CI ;11 ermits are subject to the State
of Indiana General A/�l' istrative Rules(GAR 675 IAC 12)regarding expiration time frames for beginni d . eting construction.
I,the undersigned, c-'ee that any construction,reconstruction,enlargement,relocation,or alter n st cture,or any change in the use of land or
structures reque by th•• .plication will comply with and conform to all applicable la• -• of Indiana and the"Zoning Ordinance of Carmel
Indiana-199 (a 289) a/ ndments,adopted under authority(X I.C.36-7 et seq, V •mbly of the State of Indiana,and all Acts amendatory
thereto. I '.rthe cer .111V kitchen,bath,and floor drains are connected to th�i s ry sewer. I further certify that the construction will not be
used 4l: " 444IIIIIh . .f Occupancy has been issued by the Depar nt of Community a ices,Carmel,Indiana.
Ill ,�nm4,! "'Wet 44 i t 34i L
S' ature of Owner or Authorized Agent Prin Name to
d S L
REQUIRED BASE INSPECTIONS * PERMIT FEES
*Additional inspec ons may be required. Filing / Review c �5-o- 5-0 Re-Review
Base Inspections •O
❑ Lower Footing Rough-In /Final
Cert.of Occupancy �•00 Other
❑ Upper Footing ❑ Meter Base ‘Site _
P.R.I.F.
❑ Underslab
TOTAL " 37.50
C e a.: /ll 17.4 'l 2- r0 4 / • (d, P' to /g
Reviewed/Re aced--Department of Community Services Date Fee •eceived-De,•Iment of Community Services Date
S:\Permits\Forms\ApplicationsIResidentiaNLP Application12009-08 Last Updated 08/13/2009