HomeMy WebLinkAbout0002.02 Application"ILlay C)\ Permit No.
Township 0 Application for Date
\�I)\ 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
date unless an extension of time has been officially granted by letter by the Director, Department of Community Services.
BUILDER
NAM
n
J
�l� S %� =M l /�
PHONE FAX
q
/l'�
STREET
AU
942/fT o i
CITY STATE ZIP
A
TENANT NAME
(if applicable)
OWNER
D
'rt
a1110 n, L 81 C UI
"�
STREET
010—
CITY OF GO to `� ZIP
DE ii
LOCATION
LOT
/ �`J
SUBDI ION
,g ceJ
SECTION
.2 JE Z—
ADDRESS OF CONSTRUCT�j
A. TYPr OF CONSTRUCTION
1. ' ingle Family
2. ❑ Two Family
3. ❑ Multi -Family
4. ❑ Commercial / Industrial
5. ❑ OTHER
(Specify)
B. SEWER:
Do plans include a porch?
❑ YesANo
F
Type of Foundation
❑Crawlspace
JkBasement
❑Slab
(A1541.V$ER0
TYPE OF IMPROVEMENT
I. d2f, New Structure DEC 13 2MI 1
2. ❑
Addition: Porch Room�-
3. ❑
Remodel ❑ Commercial Tenant Space
4. ❑
Foundation Only
5. ❑
Demolition
6. ❑
Accessory Building
7. ❑
Garage Detached Attached
1. � Public (Name of System C1,4R
G.
Lot Split
YES
NO X
2. ❑ Private (Septic Tank, etc.)
H.
Flood Zones
YES
NO A
C. WATER:
I.
Sump Pump
YES
C NO
1. jl�k Public (Name of System CAR J. Manufactured Trusses YES J& NO
2. ❑ Private (Well _
D. ZONING: `�^! K. Plumbing Contractor—1 d 11 L. )E, S/t j / /a .
E. ESTIMATED COST OF CONSTRUCTION
(Excluding Land Value) 3(9Plumbing License # A417 7 % ❑ UPC or ,KCABO
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
rtificate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
Q CALL PERMITS P NSPECTIONS ED:
d DP 928-64 ooting/ nder Sla Roug n eter Bas
Si nature of Owner or Authorized Agent
cc FOR PICK- Site final C/o
/J 106 Permit (Square Footage)
(Print) (Phone Number)
ewer Capacity Allotted
n Commission/BZA Docket #:
Approved: Dept. of Community Services
Inspection Fees: S5000
C`CCertificate of Occupancy: 011.0�0
II �% P.R.I.F.: a7.Gb
/ TOTAL:
Fee Received by s:\ permits\ILPapplication 6/00