HomeMy WebLinkAbout 0080.00 ApplicationCarmel -Clay /
Township
Application for
Improvement Location Permit
Permit No.
Date 1
Roll File
This permit is valid only if construction, is started within 120 days of issuance date; all construction must be completed (e/o issued) within 2 years of issuance,
date unless an extension of time has been officially grantedby letter by the Director, Department of Community Services.
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PHONH. , —5�r -.(/ 7✓(/ vl � r V O I � �� I
BUILDER
1-7 /
��i11 h V,�E h l AV Ca--rmd I N LP `f loD3 Z
TENANTNAME
p,RELEASED FOR CONSTRUCTION
(if applicable)�OOt
t0 CO
NAME
�aae
PHONE Of 9!ate ant 'L` rx 2+ s;tY°tt�a
DEFT OF COMNIAINATY t!, .
OWNER
srxEar
crry CARMELsT]CLAy"FGVeiilY.:i4�irr
L
SUBUMSION SEMON /
LOCATIO l
A. TYPE #F CONSTRUCTION
1.
LBO
Single Family
2.
❑
Two Family
3.
❑
Multi -Family
4.
❑
Commercial / Industrial
5.
❑
Farm
6.
❑
OTHER
Do lude aporch 7
[9'Yes ❑ 140
F. TYPE 9W IMPROVEMENT
I. 9 New Structure
2. ❑
Type of Foundation:
3. ❑
❑�C%xwlspace
4. ❑
MBasement
5. ❑
❑Slab
6. ❑
N 1 0 2000
(Specify) 7. ❑ Sw' I I U
B. SEWEIja � _ n 8. ❑ Garage Deta sh ad--
l. Ir Public (Name of System () (��/I7�U �� G. Lot Split YES NO
2. ❑ Private (Septic Tank, etc.) H. Flood Zones
C. WATW. U III I. Sump Pump YES NO
1. U Public (Name of System�%T�t7 J. Manufactured Trusses YES NO
2. ❑ Priva (Wgll ) L. �%. Mechaw+ca_ 0 � D. ZONING: II K. Plumbing Contractor
E. ESTIMATED COST OF C}�STRU ON
(Excluding Land Value) �lJ �( Plumbing License # /06 " ()(BOCA or ❑ CABO
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The undersigned agrees that any 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 am ,,and floor dram. a connected to the sanitary sewer. I further certify
that the constriction will not be used or occupied until tale ojOccupancy been issued by the Department of Community
Services, Carmel; Indiana. A 1 r l
Sewer Capacity Allotted 3-00
Plan Comrnission/BZA Docket #:
Reviewed/Approved Dept, Of Community Services
Igtspections Needed:
��Ie
ete
rslab ough- r e
Site inal C/O
Permit.(Square Footage) 1(pq•6r) 4Aq - —
hrspection Fees: t t
00
Certificate of Occupancy: 15,00
TOT2�� � Sl .Op
Fee
eeReceived By *.Wp% IL➢#
2