HomeMy WebLinkAbout0001.00 ApplicationCarmel -Clay Permit No. /,
Township Application for Date /
1 Improvement Zocation Permit4wmpl(c/oissucd)
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This permit 'is valid'only if construction is started within 120 days of issuance`datc' all construction must bwithin 2 years of issuance,
date unless an extension of time has been official) : ranted b letter by the Director, Department of Community Services.
NAME
PHONE
FAX
BUILDER
0065/LLa
01
-g`tiC1- /%-75
_
STREET
MY
STATE
TENANT NAME
(if $ licable)
;udiect 10c. plia"Ce With 611
NAME
PHONE
statetounty, F
OWNER
'
SnU:Er
CnY
d;
LOT SUBDVINION
SEC7RON
LOCATION
C —
A-) o L�
AD RFSS OF CONMUCnON
A. 'TYPE OF CONSTRUCTIONDo plans " clude'a porch ?
1. 19 Single Family YesbNo
2. ❑ Two Family
3. ❑
Multi -Family
Type,ofFoundation:
4. ❑
Commercial / Industrial
❑Crawlspace
5:, ❑
Farm
❑Basement
6.
OTHER
❑Slab
(specify) S CRcC*-kip
-ram - Pan C t
B. SEWER:
i
1. ❑
Public (Name of System
2. ❑
Private (Septic Tank, etc.)
C. WATER:
1. ❑
Public (Name of System
)
2. ❑
Private (Well
1
F. TYPE OF IMPROVEMENT /
—..r��_
1. ❑ New Shuctiue 1__ �__ ,
2. 6 Addition! j Porcl '' ,i ,Room I
3. ❑ Remodel' 1 I ❑ Coinmeroiel Tenant S
4. ❑ Foundatio �Dnly
s. ❑ DemolitLetached
'C 2 2 t�9
6. ❑ Accesso
7. ❑ Swimmi
8. ❑ Garage Attached
G. Lot Split NO
H. Flood Zones YES NO
I. Sump Pump YES NO
J. Manufactured Trusses YES NO
D. ZONING: K. Plumbing Contractor
E. 'ESTIMATED COST OF CONSTRUCTION
(Excluding Land Value) OO Plumbing License # ❑ BOCA or ❑ CABO
+irtrt+'+s*s+ssrtrtrtsrtss+++ss*iws•#siss+sts+sssss+rtrt+rtrtrtrtrtsrt*rt++*ss*s+++++++++*+s+tsss+ss**+++*+sss+++**+++++*++
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, laundry, and floor.draurs are connected to the sanitary sewer. I further certify
that the construction not be used,or occupied until a Certificate of Occupancy has been issued by the Department of Community
Services, Carmel, Indiana.
`Inspections
"s-1r , 1,� rJ r
✓1 Tooting/Underslab on .I Mete e
Signature of Owner or Au orized Agent
Site in /O
Kermit (Square Footage)
Inspection Fees: /z2 <7�
Fee Received By
a:V'.\AP%& m 12