HomeMy WebLinkAbout340.02 Application Carmel/Clay \ {� � ��� /7�
•a��c:mst:ip �� U1i•� Application for � Pe�tNo. <�
v Date
xoia a: { � ImprovementZocation Permit
Roll File
This permit is valid oniy if consWCtion is started wi[hin 180 days of the dace of issuance for residenrial consWCtion;and.for commercial projects,within one(1)
: ear of the date of issuance of Ihe'State 6ommercial Desi Release. All construction mus�be com le[ed(c/o issued)within 2 ears of the issuance date.
N E + j�,,,,� PFiONEn FAX r�!��
BUII:DER � I �� �'1 ��� � I� �CJ'U �
SiREET' CITY STATE ZIP
��S`�-� �#�� N �t��
TE1vaNT NaME RELEASEIa FOR CQRPSTRIl��TIOPI
(Ifa licable • „ „ �e ` „
Nnn+e p eHOVe ot' 8tata� anc9 Ler.���,edPs
� OWNER �` ��.l�l � I li� ����fVr��9l�9�C'to �Sr��`t(BCES
� i - ±Vi ,.k.. / I:L.FlX VPe➢�
STREHT ,�� CITY STATE ZIP
y vJ . I Gl �.C�i� �i�ar�,� � y(�b��
LOT SUB VISION t SECTION
LOCATION �� �L��LPi� � ��
ADDRESS'OF CONST CTION
� � n�l Gr�e�-r- C�' Cctrrr�� L N ��e�
' �1 1:. -. "_
A. TYP�E/'�F CONSTRUCTION Do plans inc�lu�a,porc �.,� /�F.�—TYP_E�' IMPROVEMENT � Q,' ��
1. �� Single�Family ❑Yes �'No ",'' `�� � n1�1? rLh New Sh-ucture • �
2. �❑ Two Family � �2:�0(r�Addition: Porch Room� �
3. ❑ Mu1ti-Family Type of-Foundati��tQ/� 2 3. �� Remodel ❑ Commercial TenanrSpace
4. �❑ Commercial/Industrial ❑�� rawlspace � ZQ��t. � 'Foundation Only
5. ❑ OT"HER 13 /Basement 5. O ���Demolition
(Specify) ❑ Slab \`6J�L❑-�j��AccessoryBuilding
B. SEWER: r�,.� n ' 7. ❑ /Garage Detached Attached
1. ❑ Public (Name of system l I � �
2. ❑ Private(Counry pemut# ) G. Lot Split � YES NO
C. WATER: „, ,, � H. Flood Zones YES �NO�
1. ❑ Public (Name of system�ar� 1�1(J , I. Sump Pump YE NO
2. ❑ Private( �permit# ) J. Manufactured Trus s � �I,�NO
D. ZONING : �� K. PlumbingContractor �,l `�i � IU` I �I
E. ESTIMATED COST OF TrR� U ION IRC Plumbing Code: ❑ Plumber's /`(��,�y�y��� _
(Excluding Land Value) �� I Indiana Plumbing Code: ❑ License#: ��r ��,��
rs*"*��+*:�«��s�s�*s**r***�**+.+**«+�**�*+�x+�«a+r«+��+rrrr+r*r*•**a�+*s+a++*.r++s:+.+�r*»«»«»«sa�r�+.*rrrrs��
I„the undersigned;'.agree that any constNetion,reconsVUCtioq enlazgement,relocatioq or al,eration of a structure,or any change in the use of land or strucmres
:requested by�this applica[ion will comply with,and conform to,all applicable laws of the State of Indiana,and[he"Zoning Ordinance of Carmel tndiana-1993"
:(Z-289)and arnend'ments,:adopted.under authority of I.C. 36-7 et seq,General Assembly of the�:State of Indiana,and all Acts amendatory thereto: I further
certify that only�&rtcheq bath,�and floor drains are connected to the saaitary sewer. I furthe�certi[y that the construMion will not be used or occupied�until a
Cer[if�i`e�°e'of Occupan`cy�f been issued by the Department of Community Services,Carmel,Indiana.
"Ilj ,,.�, ', Y�C�L�J�J / � INSPECTIONS NEEDED:
�JLtJI Il�t, r�L �i
Signature_of Owner or Authorized Agent �� � � � Footin nder Slab ough- eter Bas
��� I �I� � Site Fina �C O� �(
(Print) (Phone Number) ��� Sq. Ft.��
Filing Fees:
E-Mail: 1 l Z�1 Pf � CP���n�j,�Dm �PectionFees: 3'�5�
' Cert�. of Occupancy: a�
�c��� �•0'J�
Pla Commissio R'"Doeket#'s;TAC Date(s) P�R.I.F.: ���
TO AL: °
__ � ',
Reviewed/Approve : Dep[. of Community Services Fe � "'� ,„ � S:aermics/Fo�,nsAt,P2-02