HomeMy WebLinkAbout0006.02 ApplicationFW
Clay Permit No.
Township
a o 1,o Application for Date
/ �ij
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
.iota mless an extension of time has heen nffirinlly oranted by letter by the Director. Department of Community Services.
NAME l IA ��,.,
L IC_ t�
PHONE
ern, — }J SO
FAX SSnn
(31-�—
BUILDER
STREET
RPM l
CITY
ti
STATE ZIP
0 3 a --
TENANT NAME
(if applicable)
NAME
PHONE
FAX
OWNER
STREET
CITY
STATE
n,
LOT SUBDIVISION
SECTI N
LOCATION
Lj C4 kpadows C> ic
S u&k-_ CS-re,e*_"
ADDRESS OF CONSTRUCTION
A. TYKE OF CONSTRUCTION
1. j! Single Family
2. ❑ Two Family
3. ❑ Multi -Family
4. ❑ Commercial / Industrial
5. ❑ OTHER
(Specify)
11
Do plans include/Porch?
❑ Yes U-No
Type of Foundation
❑Crawlspace
,B 'Basement
❑Slab
B. SEWER: /
1. .X Public (Name of System d)
2. ❑ Private (Septic Tank, etc.)
C. WATER:
1. X Public (Name of System 1. 'O OSkW
2. ❑ Private Well )
D. ZONING: jH
E. ESTIMATED COST OF CONSTRUCTION
(Excluding Land Value) i'1�1 000 it 00
F. TY�OF IN�OVEMENT
1. New Structure
2. ❑ Addition: Porch Room
3. ❑ Remodel ❑ Commercial Tenant Space
4. ❑ Foundation Only
5. ❑ Demolition
6. ❑ Accessory Building
7. ❑ Garage Detached Attached
G. Lot Split YES NO
H. Flood Zones YES NO
I. Sump Pump YES NO
J. Manufactured Trusses YES NO
K. Plumbing Contractor
yot -UPC or ❑ CABO
********** *********
The undersigned agrees that any construction, reconstructi er�.'*lWition' q_ ho$Of ctil'�e, or any change in the use of land or structures
requested by this application will comply with, and co le� k�6�a , [adiasla, and the "Zoning Ordinance of Carmel Indiana - 1993"
(Z-289) and amendments, adopted under authority of LC efft:4,45T � Wb of, the Statc of Indiana, and all Acts amendatory thereto. I further
certify that only kitchen, bath, and floor drains are connected to the sf3rf td?° sewt r. I further certify that the construction will not be used or occupied until
a C rtificate of Occupancy has been issued by the Dep sq )Cbinmunity Services, Carmel! Indiana.
/ t �/j INSPECTIONS NEEDED:
. /�l .
�v; J(or) Under Slab Cough-) eter Bas
Signature of Owner or Authorized Agent
Site zFin�al C/O
[4 dA VX � i �' Permit (Square Footage) .J�-�� i�
(Print) (Phone Number)
Sewer Capacity Allotted 1.IC., a \ I ac6\
Plan Commission/BZA Docket #:
Reviewed/Approved: Dept. of Community Services
Inspection Fees: 4 3 -5d =
Certificate of Occupancy: -al L •�
P.R.I.F.:
TOTAL: �--
Fee Received by s:A permits\ILPapplication 6/00