HomeMy WebLinkAbout03120104 Application (2) CTTY OF CARMEL
;t °` "q.
° '"� MASTER PERMTT ,9PPLTCFlTTON
: cu`�; ,
�L�
`��.a .�a '
m�
Builder: �U � f� NO Y1'J`fs Date: �a'f 9 �(J.3
Tlie undersigned hereby Qpplies to the City of Carinel, Permit Services office
for an Improvement Location Permit (ILP) for Lot � �S in (Subdivision
Name) !v�lQ �{�G{y� CCy �S-f'GL1'�PS' The address of this Lot is
�aU3� I-AV � LIrh ('���e,l< Cl�Sq
The Master Plan Pile ori record with Permil Services is: (Naiiie of Model)
'�uc�P� iupka�, � �e.v z�; �'walls -k-� fG �s�- ; �r� cl< ysid�sr
3 c�c� 5�,� �a�� R+—ws
Applrcant liereby agrees fo buiJd fhe saitte sTructure that is represenled in the
appraved Masi�er Plan File on record ivii`h Permif Services. An}� alterafion to
this Qppraved p/an will require submiffing an Application for Revrsions ta
Oriqinol P/an Submifted
Vnder the penalties of perjury (Indiana Code 35-44-2-1), I hereby affirm under oath ihat
all of it�e information I have provided in this Master Permit Application is true and accurate
to the best of my knowledge m�d belief, and that I have not knowingly or intentionally
provided or oinitted any informatimi that would tend to hide, obscure or otherwise mislead iF�e
Dept. of Community Services regarding tlle truth of the matters addressed therein.
I� ✓td c�, K-eP CG�, ��82-ti, /�e�--
Name of Applicant or Agent (Print) Nmne of Applicant or Agent (Signature)
MasferPlanPile/Master Permit
nppu�a��o��
Esl. June 1999