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NAME PHONE.
BUILDER STREET CITY ST�TE _ ZIP
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NAME PHONE
OWNER STREET CITY STATE _ ZIP
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1,01' NO. ADDITION SECTION
LOCATION ADDRESS OF g,ONSTRU�,WON ,
A. TYPE OF CONSTRUCTION
1.� Residential (One or Two Family)
2. O Residential (Multi -family)
3.0 Commercial
4_0 Industrial
B. 'TYPE OF SEWAGE DISPOSAL
1.Public
_2.0 Private (Septic Tank, etc.)
C. TYPE OF IMPROVEMENT
1.0, New Structure
2.0 Addition Porch Room
3.0 Remodel
4.0 Foundation Only
5.0 Demolition
6.0 Accessory Building
7.0 Swimming Pool
8.0 Garage Detached Attached
D. PREF
1.0
2. JK
3.0
4.0
5.0
:NT USE 00 PROPERTY
-
Farm
Residential (One or Two Family)
Commercial
Industrial
Other (Specify)
E. PROPOSED USE OF PROPERTY
1. One or Two Family Dwelling
2. Multi -family
3. O Commercial
4. O Industrial
5. 0 Other (Specify)
F. ZONING CLASSIFICATION OF PROPERTY
Present j9-- I_ Proposed
G. ESTIMATE COST OF CONST UCTION
(Excluding Land Value); r�
The undersigned agrees that any construction, reconstruction, enlargement, relocation or alter-
ation 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 - 1980", adopted under the authority of Acts of 1979, Public Law
178 Sec. 1 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto.
I further certify that the construction will not be used or occupied nntilrtili,,ates
of completion and compliance are filed with the Building Commissionerndiana.
I further certify that only kitchen, bath, laundry and floor drains atary
sewer.Signatur of Owne or Authorized Agents
��C. /rrU 1S�.J ro U A 5 r 1 if r. I• r t ; f
Address
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Phone No. / r'•::r :.. -, .
Flood Zones: Yes No - A
A. O
B. O
C. 0�,,Are-
Director, Department of ommu y evelopment
Received By 17 V
Square Footage y
Building .................... wo
Certificate of Occupancy....... 1 �� 6V
Total ..................... / r 2-0