HomeMy WebLinkAbout 0079.00 Applicationel-ClV/,
Q'U Permit No. / / 'V
Township, % Application for p Date
® Improvement Location Pernel - .0 Roll File
p _
This ,permit,isvalid only ifconstructionis started within,120 days of issuance date; all construction must be completed (c/o issued) within 2 years of issuance,
date unless in extension of time has been officially granted by letter by the Director, Department of Community Services.
NAME
.PHONE
FAX
BUILDER
SIR£ET
nY
SPATE
��
Se(i f Et-1 ►
e t —
TENANT NAME
livable)
��
(if a
NAM£
PHONEY
sub
OWNER
MlC
swp�pr9r-.5 :np•
SIREEf
cn'Y
^ivw:lZA
CITY OF '�.+aisYFaFL y} TF.'^�E 3 unp
E t�
LOT
SUBDNISION
'
LOCATION
N C,S td
ADDRISS OF CONSn2DCnON'
1.
/ LCV
t
A. TYPE f,CONSTRUCTION
1. Single Family
2. ❑ Two Family
V
Do plans include orch 7 F. TYPE O_ F� PROVE 6 2000
❑ Yes 0 1. : 'fit' NewStructur
3. ❑ Multi -Family Type of Foundation:
4. ❑ Commercial / Industrial. ❑Cra pace
5, ❑ Farm went
6: ❑ OTHER ❑Slab
(Specify)
B. SEWERS/
1. Public (Name of System /
2. ❑ Private (Septic Tank,, etc:) 1
C. WA
1. Pubhe (Name o ystent r
2. ❑ Private (Well
D.
E.
2. ❑ Addition Porch _
T ❑ Remodel ❑ C
4. ❑ Foundation Only
5. ❑ Demolition
6. ❑ Accessory Building
7. ❑ Swimming Pool
8. ❑ Garage Detached _
G. Lot Split
H. Flood Zones
I. Sump Pump
J. Manufactured Trusses
_ Attached
YES NO — " _
YES NO
YESi,�NO
YES NO Jam'
K. Plumbing Contrak4A E-mj)1r\L S C r
ON o A
(Excluding Land Value) 21 oca" tea. . Plumbing License # pL\ aii31 11111CA or ❑ CABO
'�#s*s*rtrtssssss*sssssrtsr*s*+r*s**ss*+**rtrt****s*s*ss**s***a*ss***�**sinss*�*r#s****rt*rtrtrt**rt*s*ss**ssssss*ss#rt*•
The undersigned agrees thatany construction, reconstruction, enlargement, relocation, or alteration of structure, or any change in the use of land
or structures 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 only kitchen, bath, laundry,,and floor drains are connected:to the sanitary sewer. I further certify
that.the construction will not be used or occupied until,a Cer6frcate of Occupancyhas been issued by the Department of Community
Services, Carmel, Indiana
Sewer Capacity Allotted
Plan CommissionBZA-Docket -4:
Reviewed/A pr v ept. ofCommunity' Services
Inspections Needed:
tiu nderslab ougfk In eterBas
Site p
Permit (Square Footage)
InspecuonF�ees:;
IL(
Certificate of Occupancy:
TOTAL:
Fee Receiveds:uo%e� m inva