HomeMy WebLinkAbout 0777.01 ApplicationCarmel -Clay
Township
✓, Application for
ell V
Im rovement Location Permit
P
Fitmio. / 71'✓t
This permit is valid only if construction is started within 120 days of issuance date; all construction is completed (c/o issued) within 2 years of issuance
!late unless an extension of time has heen offirinlly Printed by letter by the Director_ Department of Community Services.
NAME PHONE FAX
t11 - c1
BUILDER
STREET
CITY STATE /ZIP
/ 6 O 3
TENANT NAME%
(if applicable)
NAME
PHONE S{,tb)@Ct to COn1p Ilano61Wlth all Regulations
OWNER
�.�` """�
of State and LOC2I Codes
STREET
KEPT OF CO '
CITY S A
Y OF CARMEL . �i-AY TOWNSHiF
CITY
LOCATION
LOT SUBDIVISION SECTION
dS_ 4eS7 LL L dC i /A75t.
SS OF CONSTRUCTION
ADDREnn
1 Aj
1 /+ � � ;IJ
� GAI -;�
2 -1 /019
rV
A. TYPE fdF CONSTRUCTION
Do plans inclugF a porch?
1.
0'
Single Family
❑ Yes IWNo
2.
❑
Two Family
3.
❑
Multi -Family
Type of Foundation
4.
❑
Commercial / Industrial
❑C awlspace
DC
5.
❑
OTHER
(Specify)
❑Slab
B. SEWER:
1. ,e Public (Name of System CL "1 w
2. ❑ Private (Septic Tank, etc.)
C. WATER:
1. .e Public (Name of System �„' 0 P )
2. ❑ Private (Well )
D. ZONING: S
F. TYPE 9F IMPROVE 5 M01 I I
1. V New Structure U
2. ❑ Addition: Po h
3. ❑ Remodel Commercial Tenant Space
4. ❑ Foundation Only
5. ❑ Demolition
6. ❑ Accessory Building
7. ❑ Garage Detached Attached
G. Lot Split
H. Flood Zones
I. Sump Pump
J. Manufactured Trusses
YES NO
YES NO
YES NO
YES NO
K. Plumbing Contractor JEAS
E. ESTIMATED COST OF CONSTRUCTION .�,,pp,�
(Excluding Land Value) SO, O C, v Plumbing License # lJU�2 UPC or ❑ CABO
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, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until
a Certificate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
��. INSPECTIONS NEEDED:
Footin nder Slab Rough -I Meter Base
Signatu e of wner or Authorize Agent �,
n / / Site Final' C/O
{'6I�N4 �? N (� Ni� gQ� Permit (Square Footage) �D
(Print) (Phone Number)
Sewer Capacity Allotted
Plan Commission/BZA Docket #:
Review pproved: Dept. of Community Services
Inspection Fees:
3 5—b
Certificate of Occupancy: R
P.R.I.F.: 4Say
TOTAL: I,S
Fee Re ed by s:A pemuts\ILPapplication 6/0