HomeMy WebLinkAbout0001.02 Application�` a° I -Clay �M—
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e 'tNo.TownshipApplication forprovement Location Permit
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
date unless an extension of time has been officially granted by letter by the Dirertnr_ Demrtment of Cnmmunity gervice.-
BUILDER_
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PHONE nnFAX
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STREET
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STATE ZIP
STATE
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TENANT NAME
(if applicable)
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PHONE ��
OWNER
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DEP
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STREET
CITY INp1
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LOCATION
LOT SUBDIVISION
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SECTION
ADDRESS OF CONSTRUCTION
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A. TYPV OF CONSTRUCTION Do plans include a porch? F. TYPE OF IMPROVEMENT
1. Single Family ❑ Yes�No 1. 39, New Structure
2. Two Family 2. ❑ Addition: Porch Routh
3. ❑ Multi -Family Type of Foundation 3. ❑ Remodel ❑ Commercial Tenant Space
4. ❑ Commercial / Industrial ❑Crawlspace 4. ❑ Foundation Only
5. ❑ OTHER 013asement 5. ❑ Demolition
(Specify) ❑Slab / 6. ❑ Accessory Building
/14)51-LrE)o 7. ❑ Garage Detached Attached
B. SEWER: l
1. Public (Name of SystemcM t%F_ Lam) G. Lot Split YES NO
2. ❑ Private (Septic Tank, etc.) H. Flood Zones YES NO
C. WATER: I. Sump Pump YES NO
1. Public (Name of System J. Manufactured Trusses YES v" NO
2. ❑ Private (Well _
D. ZONING: S JI K. Plumbing Contractor�jj�/sJ — �, _5/'9
E. ESTIMATED COST OF CONSTRUCTION
(Excluding Land Value) �X f Plumbing License # 0/77 ❑ UPC or XCABO
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 armel, Indiana.
i CALL PEI$`11 1 PECTIONSfNED:
�p R4�v9`zf j-64' Footing/ der Slab n Meter B'se
Signature of Owner or Authorized Agent picK UP
�R. Site FiC/
• � .� �' Permit (Square Footage) D520
(Print) (Phone Number) N
CInspection Fees: W.00
Sewer Capacity Allotted e' 4 -6l
Plan Comnission/BZA Docket #:
a�4,
viewed/ pproved: Dept. of Community Services
Certificate of Occup cy: 2( DO
P.R.
TOTS
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Fee Received by sA permits\ILPapplication 6/00