HomeMy WebLinkAbout0004.99 ApplicationEl$ per tql
Township Application for
Improvement Location, Permit
A Permit No.
�" ate
Roll File
This permit is valid only if construction is staded,within 120 days of issuance date; all construction must be completed (c/o issued) within 2 years of issuance,
date unless an eiteosioWof time has been offi6iallv Izrant6d'K 1&ter b' the Director; De irtinefit of Community . Services:
P ONE^
FAX
BUILDERLI'lod
♦ STATE ZIP
//V//
TENANT NAME
(ifs licable)
NAME
PHONE
FAX
OWNER
SrIUZ T
CnT
STATE ZIP
LOT MON
/
SECTION
�3
LOCATION
ADDRE6 OF CONMuCrI
T
9. p,
A. TYPE'OF CONSTRUCTION
1 Ingle Family
2/Two Family
3. ❑ Multi -Family
4. O Commercial / Industrial
5. ❑ Farm
6. ❑ OTHER
B. SEWER:
JATER:
ublic (NameofSystem Private (Septic,Tank, etc.)
C. /
1. public .(Name of System
1 ❑ Pavatr{Weh
Do plans 6lu a porch ?'
❑Yes o
Type of foundation
❑Crawlspace
11
asernefit
� []Slab
G.
H.
TYPE OF IMPROVEMENT
1. ,New, Stmc e
?/ ❑ Addition
3: ❑ Remodel
4. ❑' Foundati
5. ❑
6 ❑ Accessofe!
7. ❑ Sw'8. ❑ Garage,
Lot Split
Flood Zones
Sump Pump
Manufactured Trusses
Contractor
JAN - 5 191
Attached
YES NO
YES NO
YES
NO
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The undersigned agrees that any construction, recoils , on, 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 lawsof the State of Indiana, and the "Zoning Ordinance
of Cartel Indiana - 1993" (Z-289).and amendments, adopted'.. under audiorityof I.C.'36-7 et seq;,General Assembly of theState of Indiana; and all
Acts'amendmory thereto. .I further certify that only kitchen, bath, laundry; and floor drains are connected to the sanitary sewer. I further.certify
thatthe constructiomwill,notbe used'oroccupied,until a.Cei iftcate of Occupancy has been issued by the Department of Community
Services, Carmel,Indi a CALL PERMITS PLUS
®P 92� 644Z Inspections Ne ed:
Q FOR PICK-UP, ootin nderslab ough_,n , eterBas
Signature of.Owner oFAutho ed Agent
Site, final C/O
D�7 1q g
(Pratt (Phone Numb r,) [ /_rs; e t S uate Foots e> -75-.00 6
Plan, Coftumssion7BZA.Docket #r
Reviewed/Appr ved: Dept. of Community Services
JAN 0 7 1999ispec+nFees: _--0.06.
Certifichte of Occupancy: 1 S,Od
= — ��=-F
TOTAL:
OXA44 N
Fee Received By s Xr n wpm & n IV%