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lay • 0Irmit NO. �� Application for e
12) Improvement Location Permit 11 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
flats. nn1pee an vXtencinn of timi- hac heen nffirially oranted by Ietter by the Director_ Denartment of Communitv Services.
BUILDER
NAME PHONE
S
FAX
STREET CITY
STATE ZIP
'm 6 032-
TENANT NAME
(if applicable)
OWNER
NAME PHONE
FAX
STREET CITY
STATE ZIP
LOCATION
LOT SUBDIVISION
TOS TE4 �ST� %�-S
SECTION
T
ADDRESS OF CONSTRUCTION
Aq 504 S Tiei5:57T
A
IMPROVEMENT
Structure
ition: Porch Room
[q§Lel ❑ Commercial Tenant Space
t' bnly
on
sory Buildin/ /
ige Detached Att ched
B. SEWER:
1. A Public (Name of System ���s'L� of YES NO
2. ❑ Private (Septic Tank, etc.) 1P G� �r�` , f H}��Fyl� nes YES NO
C. WATER: ��Ci ,��� ,�5 G�5 Pump YES NO
1. KI Public (Name of System �Z �X anufactured Trusses YES NO_A
2. ❑ Private (Well—) G
D. ZONING: S-1 Ol�,Q Q� K. Plumbing Contractor00/5,� liPi¢D��
E. ESTIMATED COST OF CONSTRUCTION
(Excluding Land Value) no() Plumbing License # /f' 000#*PC 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,
SPECTIONS N
C
ootin nder Slab oug -I teterBa
Signa of Owner or Authorized ent Site in /O
Permit (Square Footage) (p (ODD ri704
TYPE OF CONSTRUCTION
1.
Single Family
'k
2. ❑
Two Family
3. ❑
Multi -Family
4. ❑
Commercial / Industrial
5. ❑
OTHER
(Specify)
Do plans include a porch?
❑ YesAl No
Type of Foundation
❑Crawlspace
NBasement
❑Slab
(Print) (Phone Number)
F. TYPE
1.
2.
Inspection Fees: 350.06
Sewer Capacity Allotted 508-01 Certificate of Occupancy: 11106
Plan II CRmmissiBZA Docket #: P.R.I.F.: 54700 \`I 1 ► TOTAN. ISOA.t)D .I i
Reviewe)l/Approved: Dept. of Community Services Fee(eceived by s:\ permits\11-Papplication 6/00