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� " CITY OF CARMEL
RECEIPT
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CARMEL. I�1D.__-__.._ .. � - I _. 19 �%.� .
RECEIVED FROM .��,:.L2.t� _Ccc,���,�, �� �o �
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THE SUM OF ��_� � �� /� ,� a.
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ON ACCOUNT OF—._(� _ (`���y�y,���-
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APPLICATION FOft I�iPROVEA'IENT LOCATION FEE PAID �/�� S. U Z
PE;�'�i.[T AND CERTTFICATE OF OCCUPANCY COVTR. ' 1�I,G ,{/
NANTFc ,Y _ . �f _. , ' PHONE _
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. LOT �NO , , ADDITION -; `_ SECTI�N
Lo�atr on _� .> �, ��.`���E.-;> ; �,.,� F�
DDRESS OF CONSTRUGTION
A. :TYPE;OF CONSTRUCTION . Td USE F` P
1.;8'Residential (One or two family) 1. D�arm
2. p Residential (Multi-family) 2. Cz1��Residential (One or two family)
3• � Commercial : 3. ❑ Commercial
4. p Industi�ial 4. ❑ Industrial
B. TYPE OF SEI�lAGE DISPOSAL 5. ❑ Other-specify
1. O}'ublic E. PROPO�SED USE OF PROPERTY
2. p Private (Septic tanlc, etc. ) 1. �jOne or' two family dwelling
C;. TYPE ,OF TD�IPROVE NT 2. ❑ Multi-family
1.'(Q I�ew structure 3. ❑Commercial
2_. O t'�ddition Porch Room '4. pIndustrial
3. O Remodel 5. p Other-specify
4. ❑ Four�dation only
5. Q Demolition F. ZONING CLASSIFICATION OF PROPERTY
6. C7 Accessory Building Present �•-/ Proposed S-- /
7. p Swimming Pool G. ESTIMATE COST OF CONSTR NOT IN-
8. Q Garage DetachEd Attached : CLUDING LAND VALUE /-,S"C'; C"ir '� `"-'-
I h�reby certify that I have the authority to make the oregoing application,
that the application is correct, and that the construction will conform to the'
regulations in the Building Code, the-"Zoning Ordinance of`CarmeT, Indiana -
"1961," and amendments ther�eto, adqpted under the authority of Chapter 1'74 of the `
Acts of 1947, Ceneral Assembly of the State ol Indiana, and all Acts amendatory
-thereto, or private building restriction�, if any, �n�hich may be imposed'�n:the
above property by deed.`
T�'urther certify; that no in;iui�ious drainage of area or damage to public
property will result.from th�s construction and site grading shall conform to
the subdivision deve].��,ment plan as_approved by�Carmel-Clay Plan Commission,
if any. ..�._ , , _
I further certify that'�the_construction will not be used or occupied until
proper esrtificates of compl'etion and compliance a`re filed with the Building
�ommissioner's Office, Carmel, Indiana.
I further certiiy that only kitchen, bath, laundry and floor drains are`
.connected to sanitary sewer.
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ignature of' Owner or Authorized Agent Address City State Date:
11-5-77 {• ' a / 1/�1.'c�ir- ,�/ �� t;
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