HomeMy WebLinkAbout0004.02 ApplicationWarmel-Clay Z V 1 Permit No. 11-4 j
*ownship J . Application for Date
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. Denartment of Communitv Services.
BUILDER
NA PT A
K&4,y\,
PHONE
. K
/ FAX
{Q �
�%�— 172L—
STREET -n� d4couCIT
Vj
STATE
nd
ZIP
�06
TENANT NAME
(if applicable)
NAME c
PHONE
FAX
OWNER
STRiEEET} l
CITY
STATE
ZIP
LOT SUBDIVISION
SECTION
LOCATION
ADDRESS OF CONSTRUCTION
A. TYPE OF CONSTRUCTION Do plans include a porch? F. TYPE OF IMPROVEMENT
1. ❑ Single Family ❑ Yes No 1. ❑ New Structure ohhent '
2. ❑ Two Family 2. Addition: Porch Room_y'-
3. ❑ Multi -Family Type of Foundation 3. ❑ Remodel ❑ Commercial Tenant Space
4. ❑ Commercial / Industrial rawlspace 4. ❑ Foundation Only
5. '`/ � OTHER ❑Basement 5. ❑ Demolition
(Specify) )1rlpfljK_ ❑Slab 6. ❑ Accessory Building
B. SEWER:
add 'pvt txy l5 7. ❑ Garage Detached Attached
1. Public (Name of System ) G. Lot Split YES NO_Y_
2. Private (Septic Tank, etc.) H. Flood Zones YES NO__y
C. WATER: I. Sump Pump YES - —NO�
1. Public (Name of System ) J. Manufactured Trusses YES
2. Private (Well ) AA
/A--
D. ZONING: K. Plumbing Contractor
E. ESTIMATED COST OF CONSTRUCTION
(Excluding Land Value) t Ito. U no Plumbing License # ❑ 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 Certifi ate of Occupancy has be issued by the Department of Comm'nTi%sp iciarmel, Indiana.
n CALL PERM tt''LL--U� INSPECTIONS NEEDED:
DP 928-6447 ootin nder Sla ough- Meter Base
Signature of Owner or Aut"gen,FOR PICK-U�Site Final C/O
{o Permit (Square Footage) Ts
(Print) (Phone Number)
Inspection Fees:
Sewer Capacity Allotted RELEASED FOR Ta6U TQ&cy: ZI
Suboct to compliance ti labons
Plan CommissionBZA Docket #: —` State and tr.
o @S
DEPT OF cOmmuNAviiG 2
CITY OF CARMEL / CLAY T
Il�lC�►i",tf
s:\ permits\ILPapplication 6/00
Reviewed/ pproved: Dept. of Community Services Fee Received by