HomeMy WebLinkAbout04040166 Application ��` �� _ oy��'o/�.�
. Township Application for � Pe�t
Date
xoza#: Improvement Loeation Permit Roll Fl�e i,�
This permit is valid only if cons�uc5on is started within 180 days of the date of issuance for residential construcuon;and for commercial �e ,within one(1)
ear of the dare of issuance of.the State Commercial Desi ��Release. All consauction must be com leted c/o issued within 2 ears of the issuance date.
NAME PHONE j�I � � \ FAlX,,/
BUII;DER C � �l[111�^I.�+�J + �U�ID�I
S�-/V�5 � . �T�S{. CITY� . C i.. � �I'J �TE � ZIP / �
N
TENANT NAME � � Z
(Ifa licable) � � � �
NAME G PHONE � � } FAX �
OWNER �L/ Z L �
S7REHT CITY U � J � ` STATE ZIP
� C C J
LOT SOBDIVISION I, � �� O � SECTION
LOCATION � ' : j,� '�V�— ±� ° J Q �
� ADDRESS OF CONSTRUCfION u� � O O
Iy�F�( 1C 1 � U .� �
�t.J`� � Y`Of�T � .J C.'' �f
a.
A. TYPE OF CONSTRUCTION�{o plans include a porch? QF� TY�� IMPROVEMENT
1. � Single Family ��� - Yes�O No 1. C�'ew Shucture
2. ❑ Two Family 2. ❑ A
3. ❑ Multi-Family � ��y pe of Foundation 3. ❑ R ei S e
4. ❑ Commercial/Industrial �a,°�,�J � Crawlspace 4. ❑ F n.Only
5. ❑ OTHER �D�+B�asement � 5. ❑ D on ppp 2 t ��
(Specify) 6�Slab v 6. ❑ A Bfifidiftg
B. SE R: (76`� cy 7. ❑ G etached tta
1. �Public (Name of system �� l�
2. ❑ Private(Counry pemilt#� ) � '� G. Lot Split ,
C. WATER: ` Flood Zones YES NO
1. Public (Name of system �1 � '�-i � - �� I. Sump Pump YES � NO
2. �Private(County permit# ) 7. Manufactured Trusses YES [ NO�
D. ZONING : J� / '�, K. Plum6ing Contraetor �� L . ��}�i7h
E. ESTIMATED COST O CONSTRUCTION �(! IRC Plumbing Code: � Plumber's I O �
(Excluding Land Valu �'' ` � Indiana Plumbing Code: O License#:
��r�r*�>:..:+:++«�s�+r+r. +�.»+rs�+«r�.++.z.�«.��+s.+.*�«*..s+*�+**r:.x:»*a.�s�rrt*.s�+a.+*s.s•.*+�s�«s++�*r
I,the undersigned,agree that�any conshvc[ioq reconstruction,enlargement;relocation,or al[eration of a structure,or any change in the use of land or structures
requested by this�application will comply with,and conform to,alTapplicable laws of the State of Indiana,a�d the"Zoning Ordinance of Carmel Indiana-1993"
(Z-289)and amendmen[s,adopted under authority of I.C.36-7 et seq,Generel-Assembly ofthe State of Indiana,and all Acts amendatory Ihereto. I further
certify that only kitchen,batfi;and floocdrains are connected to[he sanitary sewec I further certify[hat the construcfion will no[be used or occupied until a
Certifecate of Occupancyhas been issued by the Department of�Community�,Services,Carmel,ludiana.
4�� ' � �.,,{_ ��� INSPECTIONS NEED .
�nL
Signatur f Owner or Authonze Agent Footin nder SIa u - eter B se
���Ll.! ��Y1 �v7C /155�'1 ")L��Q�� Site Fina C/O
(Print) V�— (Phone Number) +� � O Sq. Ft:_��
Filing Fees:
E-Mail:�� 1�-'�VU�Q�IW IUIG,p�������UI�VJOC� BaseInspections: � �o�_ 0 ��G
� � Cert. of Occupancy: .5�� �G�
PlanCommission/B7 A�/BPWDoc et s; A D e(s) P�R.I.F.: .S�/• G�
��'dA9 TOTAL: �'
i �
C2-v r
,.�
Reviewed/Approved: Dept of Community Services V��e� iv� � � S:Permits/Fortns/[LPS-02
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