HomeMy WebLinkAbout 0778.01 ApplicationWY l Permit No. " 1 V " q
Township /
O I Application for Date
1�6
Improvement Location Permit Roll File
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
.1.,tu ,..,IAcc aavtPnci— of time hac hPPn nffirially vranted by letter by the Director. Department of Communitv Services.
NAME
PHONE
FAX
BUILDER
I "
STREET
CITY
STATE ZIP
NAME
(if applicable)
LEASED FOR CONSTRUCTIONTENANT
Subject to cot ►><Piiartce with all R
OWNER
NAME
I'
PHONE
anLocal Codes
DEPT OF CVIIVIUNITY SERVICES
OF C
STREET
CITY
A�99 //pp
SANDIANAIP
LOT SUBDIVISION
SECTION
LOCATION
ADDRESS OF CONSTRUCTION
ol
A. T,PE
OF CONSTRUCTION
Do plans incLuo a porch?
F. TYPE
F IMPROVEMENT
1.
I��`
Single Family
❑ Yes PI�No
1.
PS,,New
Structure
2.
❑
Two Family
2.
3.
❑
❑
Addition:
Re 1.0 E
3.
❑
Multi -Family
Type of Foundation
em
4.
❑
Commercial / Industrial
❑Crawlspace
4.
❑
Fo Only
5.
❑
OTHER
�<asement
5.
❑
Dembl)tiW,
(Specify)
❑Slab
6.
❑
Acces: � B,uildi*
7.
❑
Garage k 44ed
ercial T ant Space'
0-1
B. SEWER: V vim'
1. XPublic (Name of System cour ) G. Lot Split � ' NO !/
2. ❑ Private (Septic Tank, etc.) H. Flood Zones \��4ES NO:
C. WATER: I. Sump Pump YES O
1. Public (Name of System ) J. Manufactured Truss46YES NO
2. ❑ Private (Well )
D. ZONING: — K. Plumbing Contractor m2im N i ri
E. ESTIMATED COST OF ONSTRUCTION ��[[
(Excluding Land Value),, M-,) Plumbing License # Jp(3q 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 /Under Slab �ough eter Ba
Signature of 4Owner or Authorized Agent qJ
Site �Fina /O�
_ (0 Permit (Square Footage) r% 115�&
(Print) (Phone Number)11X�o1
Sewer Capacity Allotted D sua, o
Plan Commission/BZA Docket #:
I
Reviewed/Approved: Dept. of Community Services
Inspection Fees:
Certificate of Occupancy: 0
P I.F.: 6'-�o ?
TO S
Fee Received by s:\ pemiitsAI-Papplication 6/00