HomeMy WebLinkAbout 0790.98 Application.Carme Clay Permit
P �i Date Application for T r
Improvement LocatidnTermit Roll Ei'e
'This permit is,yalid only, if construction 'isstarted within,120 days of issuance date; all;construetigpmost be completed (c/o issued) within 2 years of issuance,
date unless an extension of time'. has been officlall ' ranted-b letterti .the Director, artmentbf Commurii "Services.
BUILDER
NAMIIE n/�
. �. I' l�' '-
PHONE
13 ?1 8 - � CI K3
FAX
:.
STREET
^^ CnY
f,r.
CAr(f)e IJ
'STATE ZIP
LI6U32-
TENANT NAME
� 1
`l1v/A
'�
(if applicable)
vJ
NAME ''nnnn
2� r�
PHONE
! //�
u C{ yVA��`/OnCe.*ith all R SgfI
` Y� 1/T �{i .O►4
OWNER
ter, 1
L A
31 ? iS $ - l �P�at�Catnt
OF O?Ty
�DP*QNT
c
LOT "'S
,
DMSION
1OA
-
rouk!r
LOCATION
a
G
ec. o n .
ADDRESSOF CONSTRUCTION.
SA Mc_ A,s
,9
A. TYPE OF, CONSTRUCTION Do plans in de'a porch . ' F. TYPE, ,IlIIPROYEMENT
1. ❑ Single Family' • es ❑'No \ w Structure,
2. ❑ Two Family Addition Porch ZRoorn
3. ❑, Multi -Family Type of Foundation: 4 ❑ Remodel �� � ace
4. ❑ Commercial / Industrial ❑Crawlspace, �I6 4. ❑ Foundation orgy➢
ID
5. ❑ farm ❑Basement l 5. ❑ Demolition
6. OTHER �^.�) I❑_Slab 1 6, ❑ Accessory Building, JUN
(Specify) scLeer.t Por-c 1 1 7. ❑ Swimmmg'Pool 2 9 .l5'4
to ,�!z�
B. SEWER: 8 ❑ Garage Detached Attached
1. ❑ Public (Name of System r��a� G. Lot Split. 0 2. ❑ Private (Septic Tank, etc.) U `L Ii Flood Zones rENOC. "WATER: 1 I. Sump Pump O1. ❑ Pubhe (NameofSystern ) �J. Manufactured'Trusses O
2. ❑ Private (Well
D. ZONING: K. Plumbing Contractor
E. ESTIMATED COST OF ONSTRUCTION
(Excluding Land Value) 9, 1 SE7 , U d' Plumbing License #' ❑ BOCA or ❑ CABO
The undersigned agrees that any construction; reconstruction, enlargement; relocation, or alteration of structure, or any change in the use of land
or structures requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "ZoningOrdinance
of Cannel Indiana--1993" (Z-289) and amendments, adopted under authority of I.C. 36-7 etseq;.General Assembly of the State of Indiana,and all
Acts amendatory thereto. I further certify thatonly, kitchen bath,—laun ,and --floor drains are connected to the sanitary sewer. I further certify
that the construction will nm'be used'or�occupied�tintil a Certificate Occupancy has been issued by the. Department (ifCommunity
Services, Carme1judiana. MOM0 Rc-
Inspectko►kjNeeded: 6 ks—
Signature of Owner or.Authorized Agent \ �I //
roM/
111fi�ti4(avAil y 158-S 1
(Print) j (Phone'•Num •er) (\; � /
Sewer Capacity Allotted �/ / /�/
(Square Footage)'
Meter Base
v+o
i
r-
s:Vb.\d, 5gh/s'.IZN6
G!1/CLd-c�1—�