HomeMy WebLinkAbout03090127 Application Carmel/Clay- s�
, Township Application for �,�, � Pe�„�it No.�-Z 6�
Hold#:
Improvement Location PermqY'V Date
�.i\ Roll File
This pennit is valid only if conswction is started within 180 days of the date of issuance for residential construction;and for commercial projects,within one(1)
ear of the date of issuance of the State Commercial Desi rtRelease: All conswcoon must be com lered do issued within 2� ears of the issuance date.
NAME PHONE FAX
BUILDER � G6 . S— �J� ` �S• � 6D S��/
:,
ST�T(/o� 3'�,d v� or,,w A STATE��vZJ�—
TENANT NAME �/�
(Ifa Iicable Nft'C"
NAME PHONE PAX
OWNER /�I F--C� � /��-
STREET N��� CITY STATE ZIP
OS C-0U/T C � / �3
LOT SUBDIVISION SECTION
LOCATION I S 05�� ���� I��
�L �T�
ADDRFSS OF CONSTRUCfION �y�J�
3/ �IAZ�� -a5 i�- - f I 'SFp 1
A. TY�OF CONSTRUCTION Do plans include a porch? F. TYPE OF IMPROVEMENT $y. ?
1. Single Family ❑ Yes ❑ No 1. ❑ New Shucture '__
2. ❑ Two Family 2. ❑ Addi[ion: Porch_Room
3. ❑ Multi-Family Type of Foundation 3. � Remodel ❑Commercial Tenant Space
4. ❑ Commercial/Industrial ❑ Crawlspace � 4. ❑ Foundation Only
5.� OTHER ❑ Basement �[j{ 1� 5. ❑ Demolition
(Specify) �., Slab �!��� 6. ❑ Accessory Building �
' B. SEWER: 'f'.+, " ,rp 1" _�t� 7. �, Garage Detached Attached
1. �� Public (Name of system G�d'���/
2. ❑ Private(County peanit# ) .D� G. Lot Split YES NO_�
C. WATER: E Flood Zones YES NO�
1. � Public (Name of system �C(A,tti�.} ��II. Sump Pump YES NO
2. ❑ Priva[e(Co permit# ) �� J. Manufactured�Trusses YES NO�
D. 7ANING : � �K. Plumbing Contractor
E. ESTIMATED COST OF CONSTRUCTION IRC Plumbing Code: Plumber's ��� �
(Excluding Land Value) `� /'7�i �Z7 Indiana Plumbing Co e: ❑ License#: �/7��
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I,the undersigned,agree that any construction,reconstruetion,enlargement,relocation,or alteration of a strucmre,or any change in the use of land or structures
requested by this�applica[ion will comply with,and confortn ro,all applicable laws ofthe State of Indiana,and the"Zoning Ordinance ofCarmel Indiana-I993"
(Z-289)and amendments,adopted under authority of I.C.36-7 et seq,General Assembly of the State of Indiana,and all Acts amenda[ory thereto. 1 further
certify that only kitchen,ba[h,and floor drains aze connected to[he sanitary sewer. I further certify tha[the construction will uot tie used or oceupied until a
Cerrificate af Occupancy has been issuedby�the Department of Community Services,Carmel,Indiana.
��_� �CTI � ED:
Signamre of Owner or Aut onze Agent � 1 I ootin � nder Sla " n h-In Meter Base
�
� , S/A/�-7�-/� �DS• lo�(o() �� Site �ina ° C/o�
(Print) (Phone Number) � , �'L S4.Ft.
Filing Fees: � ���' �O
E-Mail: Base InspectionsW/
.X
Cert. of Occupancy: .
Plan Commission/B7.A/BPW Docket#'s; TAC Date(s) P R.I.F.: � („� � SD
�ty
� ^ � TOTAL:
����L/
ReviewedMpproved: Dept. of Community Services Fg, Rec i ed / ?�rtnits/Fortns/ILP5-02
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