HomeMy WebLinkAbout 0078.00 ApplicationCarmel -Clay
Township
0
Application for
Improvement Location Permit
Permit
Date ' 11
'`JJ�✓ Roll File
if construction is started within 120 days of issuance date; all construction must be completed (c/o issued) within 2 years of issuance,
of time has been officially granted by letter by,theDirector, Department of Community Services.
NAME `,11 PHONE
l l On/)L`3 1 " -2Z00
FAX
q) 5 - 220
BUILDER
_
STREET CfrY'
SFATE ZIP//
�10 ,
t� GZ1 t)
TENANT -NAME
S(A
(da livable):
ry) i''
NAME PHONE
FAX
46
�FA^�
OWNER
`
STREET CITY
Pp
A �h
�
LOT SUBOMSION'
LOCATION
ADDRESS OF CONSFRUCTIONMOB
— Li r.rr tQ -
A. TYPE OF CONSTRUCTION
Do plans include ,orch ?
F. TYPE.OF,BIPROVEMENT
1.
Single Family
❑ Yes ' , o
1.
�
New Structure
2.
,C�
L0
Two Family
2.
❑
Additi a =
3.
. Q
Multi -Family
Type of Foundation:
3.
❑
Remod (� c !
4.
❑
Commercial /Industrial
❑Craw
4.
❑
Found J[�i t y
5.
'❑
Farm
cement
5.
❑
Demot
6.
❑
OTHER,
❑Slab
6.
❑
Acres dintg�N % ZQQQ
(specify) 7. ❑ Swirm(t(tgLPool J
B. SEWER: 8. �al Garagj(J�Det�ched----,�.>...�.
1. 54 Public (Name of System &em e ( ) G. Lot Spit YES NO
2. ❑ Private.(Septic Tank, etc.) H. Flood Zones --I'ES —3I6—
C. WATER: I. Sump Pump YES X NO
1. IR Public (Name of System bayntZ ) J. Manufactured Trusses YES —_ NO
2. ❑ Private'(Well )
D_ ZONING: S— I K. Plumbing Contractor Ae$
E. ESTIMATED COST OF CONSTRUCTION
(Excluding land Value) 83 4 l9 Plumbing License # 04 Z30z BTr0CA or ❑ CABO
The undersigned agrees that any construction, reconstruction; enlargement; relocation; or alteration of structure, or any change in the use of land
or strict res requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance
of Carmel Indiana - 1993" (Z-289) and amendments, 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 onlykitchen, bath, laundry, and floor drams are connected to the sanitary sewer. I furthercertify
thatthe constnrctiioo will not be used oroccupied until a Certificate of Occupancy has been issued by the Department of Community
Services, Carmel, Indiana op �r/ Inspections Needed:
�. : I d �S I oot' ,Undei idab ouM ter B
Signature of Owner or Authorized Agent
.Site iaa! C/O
bEAry V_\n9DCC'�
(Print) (Phone Number) Permit (Square Footage) 145,00 4otrt
Sewer Capacity' Allotted (D, 20e0. n Inspection Fees: 60.06
(�r l 4.
Plan CornmissionBZA Docket #: Certificate of Occupancy: 15.00
ITOTAL: 4 AIA44,0
Reviewed/Ap roved:: Dept. of Community Services Fee Received By S: ro�wp% & M Ivse