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HomeMy WebLinkAbout13050007 Application ..t -‘4 ,t49,,,<„--P C4ggr< ' CITY OF CARMEL / CLAY TOWNSHIP- . ' MIT # I3oSa0o7 c .., u RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION' " R Sewer'/,Water Utility' "�"4c'. r 70,, For New Structures,Additions,Remodels,and Accessory Structures.. Permit# BUILDER NAME PHONE FAX OF ,I A4 °L - 3l7-S02-.633 RECORD STREET ADDRESS: CITY" STATE • ZIP 62.0 r_ Zs&n i n y62)-3( E-MAIL ADDRESS EST METHOD.OF CONTACT 3 i7 -S-0 z-6 CriF PLUMBING NAME -' STATE OF INDIANA PLUMBING CODE CONTRACTOR LICENSE NUMBER O IRC -❑ UPC PROPERTY NAMES PHONE FAX OWNER Ilaorn"V I) 1.1. 13 %• 37 STREET ADDRESS �1 t U E I YI L. STATE ZIP V L CAP PROJECT LOT NUMBER SUBDIVISIO E SECTION LOCATION f33 4rroco , ' MAY ® 1 2 13 . -STREET ADDRESS CITY STATE ZIP 2f0 - 4rr O.WL✓ Z ®,:,rV'{i. Wm - :-;C(b . L TAX MAP.PARCEL NUMBER - - _u_ FLOOD ZONE IS / / o2-oo'1 obs3 0006 x uNStmd f LOT SPLIT SEWER UTILITY WATER UTILITY ',SEWER/WATER ❑ YES D NO UTILITIES EXCAVATOR TYPE OF TYPE OF CONSTRUCTION MASTER PERMIT FLOORPLAN PERMIT X SINGLE FAMILY O TWO FAMILY' ❑ TOWNHOME O YES; O NO TYPE.OF IMPROVEMENT go0'g on/y EARLY RELEASE ❑ NEW.STRUCTURE 0 REMODEL O ATTACHED GARAGE C ACCESSORY'BUILDING'. i['.ADDITION-'D,Room/s Q.'Porch O;Deck O.BASEMENT FINISH O DETACHED,GARAGE ❑ DEMOLITION ❑ YES ❑iNO PROJECT PLAN COMMISSION/,;BZA/,BPW DOCKETNUMBER/S AND/OR ESTIMATED COST SQUARE FOOTAGE TAC DATE/S OF CONSTRUCTION, le. /. crO EXCLUDING LAND '!f ...", 000 /e L POF.PLANS TYPE OF,FOUNDATION MANUFACTURED SUMP PUMP PORCH O. CD E-MAIL ❑ SLAB' O BASEMENT-❑WALK-OUT TRUSSES 0 CRAWLSPACE ©' POST&'BEAM O.,POST&PIER O YES. 0 NO O YES O NO $-YES O NO STATE OF CDR NUMBER RELEASE DATE CONSTRUCTION TYPE OCCUPANCY.CLASS INDIANA CDR SCOPE OF RELEASE TYPE OF RELEASE FOR TOWNHOMESi O FDN L7 STR C ARCH O ELEC O MECH ❑ PLUM cl SPKLR O OTHER For Single Family and Two Family Dwellings this permit is valid only,if construction commences within' 80 days of the date'of issuance of this.permit and must be completed,having the Certificate of Occupancy issued,within 18 months of the date' i u Class 1 Structure Permits are subject to the State ad completing construction. structures undersigned,requested bwthis a any application will comply strucation,enla p i ,• `a it, laws` ration off Indi ture,or any'change in the use of land or n Indiana General Administrative Rules GAR 675 IAC 12)regarding expiration Ik qu pp comply of the State of Indiana and the°Zoning Ordinance of Camel Indiana-1993"(Z-289)and amendments,adopted under au 1. . 6-7 et seq,General-Assembly of the to of Indiana and all Acts amendatory thereto. I further certify that only kitchen,bath,and floor drains are connected to the sanitary_sewer. I further certify,that the construction will not be usedoroccupied�, ti aCertifipte of Occupancy has been issueilhy the Department of,Community Commuty Servicrs,Carmel,Indiana. g s SVIA Signature o : -iAuthonzed Agent 'Printed Name � Dam REQUIRED BASE INSPECTIONS * PERMIT FEES (7 c' ac *Additional inspec us;may be required. t Filing / Review Re-Review J/ Base Inspections I 1 a .C� ❑ L e-r.Footing; Rough-In L�J Fi (A 'Cerl.of Occupancy �(J Other Upper Footing ❑ Meter Base Site P:RiGF: . ❑ Underslab ' TOTAL 3a. l 5 �[ 3 C y c Ms-0-r 5'7.1' k r C Reviewed/Reliase I-Department of Community Services Date Fee Recened' Department of Comm ontty Services Date ...... ........ ........ .................... ............. 8.Wennt.worms\App&aiionstaes,dentiNLP'Apptcaiion\2009-08 Last Updated 08/13/2009,