HomeMy WebLinkAbout 0775.01 Signed Demo07/05/01 15:02 FAX 317 776 8506 HAMILTON CO. HEALTH DEPT 002
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To IJw srlbmitted wiftt 0pplimOon*: Two, copies of a site 10c1tion map, clearly Identifying the structure or
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thorn pFirt corm n�aur�tie liter>i P'�rn�il 5�/vittry.}
C:nri�in inr�avc pins are required rel-1"ng to prfvate wells, seplie sysren„ ano fuel'tanks, prior to
tini»rt! iti o l�.
xl�tinq_w�/I� W -rl 01tud be plugged according to Well ardirtanc,a A-62.
F1'i5fin septrc; Septta aYstet» must be pumped and fiffed with aand, or removed. It saptie
SiYubdm iA W Lie roused, it must be plugged Off unIII ready for ro,,ugp.
Fu$! Tanks: Fuel tanks must be pumped and removed frorn building andfor property.
Address od„molitYan; 24b ti 95th 3trest ndisrtaP��S� end. 467.810o
Tho 04Y of Carmel andllor 1 jaj", y1,on Cnia?ty Hc,lth hR1)1 must perfalm en P?speafi0rr prior to civmolitror?.
i�r vl l!"tt� t117p1OvQ lfia L'atr ilan Aerrn(., applicant is requineaftn nI n rhly form la)dnrldu'0/S has , ,, l 9 and, to t#e
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sut+mi6 yc�rrr �rp1tt11>G�tJur'r p<•�kagd.
I. Morris Hensley, Supervisor: Water rr..'611ent operartnrts, City Of Carmel; (317) 511-2654.
2. VoeryMclllultyt Hamilton CauntyHealth DepL; (311) 77&85(16 LLA
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tan. fraSi cy� �,, (, gnature $Date: MOt'rgs HeAslay(vr re alive)
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NO7F• $1,01)lr1 "pprnvOls be floquired from atherSbte orlocslgovemrnonf enli(los, or u(ilifies (other
/�,�n fl�a;?e I�drYr��„sect lienelrl}. ff is fhe sofo responsibrigy of the corteMMe of record to i6l iNj such
1pprovrals
Under V)V rlcttiall ez of wl"Joy VndWQ Cad* 93-44.2.1] t hft aPRnn un
+ppliwlle� fc+r eamWlgon porrnu Is tN9 aad sceuraor w the b @t o1 der oafh lhbr aifl of the Mformntion I have prorid041n curs
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Permit Sarvfcos: One civic Sgvgm; Carmel, IN 46032 1'h, (317) 571-Z444 fax ('3r7J 571-,7,40g
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07/05/01 15:01 FAX 317 776 8506 HAMILTON CO. HEALTH DEPT
16001
HAMILTON COUNTY HEALTH DEPARTMENT
ONE HAMILTON COUNTY SQUARE, SUITE 30
NOBLESVILLE, IN 46060-2229
PHONE (317) 776-8500
FAX (317) 776-8506
FACSIMILE COVER LETTER
NAME: o �Q,�d( FAX PHONE NUMBER: 573- 39
COMPANY:ac'a K r
FROM: Ar,01gs4.r
COMMENTS: '/
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Total Number of Pages, indud"ung Cover Letter a2,
Date Transmitted: 5�14/ Time Transmitted; e9: = S
IF YOU DO NOT RECEIVE ALL THE PAGES, PLEASE CALL BACK AS SOON AS POSSIBLE
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