HomeMy WebLinkAbout0292.80 ApplicationCARhiEL-CLAY TO�tTISHIP
APPLICATION FOR IhTPROVEhTENT LOCATIOti
PERMIT AND CERTIFICATE OF OCCUPANCY
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�Yilder � �-`
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NMIE
Owner S�M� /3 s'
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LOC�bI O� L� Y0. ADl
DDRE�S OF CONSTI
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DATE :SSUED C�— � ;� �- ��(�
FEE PAiD "' � -L{ �-{
COiITR. R�G, ry
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�•[�Residential (One or two family)L 1.w0 Farm�� vr t�!tpYr,F.TY
2. p Residential (Multi-family) 2, Q-Residential (One or t�ao family)
3. ❑ Commercial 3. ❑ Commercial
4• p Industrial 4. p Ind�,strial
�. YPE OF SEWAGE DISP05AL 5• ❑ Other-specify
�. Q-Public
2. q Private (Septic tanlc, etc.) E• PROPOSED USE OF PROPt,RTY
C. T P OF IrIPR VEhIEPIT �• �1-6ne or two family dwel'_ing
�• B'New structure 2• ❑ Multi-far�ily
2. O Addition Porch Room 4, �� Commercial
3. ❑ Remodel — — ❑ Industrial
4. ❑ Foundation only 5. p Other-specify
5. ❑ Demolition F. ZONIiIG CLAS�IFICATIOCI OF PROPERTY
6• ❑ Accessory Building Present Pr�oposed
7. p Swimming Pool �
8. D Garage Detached Attached G• ESTIMATE COST OF COA'S�R. I�OT IN-
— — CLUDING LAND VALUE � 70, pgp �'_i
I hereby certify that I have the authority to make the oregoing application,
that the application is correct, and that the construction will conform to the
19611atan�nSamendmenBslthereto�dadopted undergthedauthority ofrChapterd174aof the
Acts of 1947, General Assembly of the State of Indiana, and all Acts amendatory
thereto, or private building restrictions, if any, which ma tr-i posed on Lhe
above property by deed. ,��``;gl��,
I further certify that no injurious drainage of area,,p dam9�a.,�Tf �public
property will result from this construction and site gr ing sha1Z. form to
the subdivision development plan as approved by Carmel� lay;Plat� Cpfi i&sion,
if any.
I further cerCify tt���_ttho c;Snstr}�ctio w;i1,1� not be � sed, or� �
proper certificates of�'oompletiqn,and compliance are ff� d tvithQth�P �¢ until
Commiss.ioner's Off'ice, Carmol,'Indiana. � tlilding
I further certify that only kitchen, bath, laundry and'�. ains are
connected to sanitary sewer. n
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Signatu e of Owr,er or Authorir_ed A�;ent Address
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