HomeMy WebLinkAboutBuilding Permit�n� a Clay Improvement Location Permit Permit N
Township Date -
This permit is valid only if construction is started within 120 days of issuance date; all construction 'iscompleted (c/A0 incuafi within
(2) two years of issuance date unless an extension of time has been officially granted by letter by the Director, Department of
Community Development.
BUILDER
NAM / PHONE
v /�
STREET I STATE ZIP
+� r
NAME OF BUSINESS
t'IF APPLICABLE)
NAME �-+ PHONE
v^':-YNER
STREET CITY STATE ZIP
LOCATION
LOT SUBDI ISI N_ SECTION
ADDRESS O�N� N
A. TYPE OF CONSTR CTION
1 � Residential or Two Family)/Z w'
2. O Residential (Multi -family) ((,i ��'�'
3. O Commercial
2.A Residential (One or Two Family)
3.0 Commercial
4. Q Industrial
5. Q Other (Specify)
4. Q Industrial i E. PROPU ED USE OF PROPERTY
5. Q Institutional �� ;� 1. On or Two Family Dwellin
B. TYPE OF SEWAGE DISPOSAL
IX Public (Name of System
2. Q Private (Septic Tank, etc.) �
C.
g
�2.0 Multi -family
aih 0 Commercial
Industrial
TYPE OF IMPROVEMENT5. Q Other (Sepcify)
LA New Structure / >, �6in_nirniG CLASSIFICATION OF PRO TV
2.0 Commercial Tepa n t Space,-, Presentv
3. O Addition Porti, Room G:"'ESTIMATE COST OF CONSTRUCTION
4. 0 Remodel `r_' (Excluding Land Value) d�A. o
5. O Foundation Only f .
6. 0 Demolition 0-�' `• - H. Lot Split Yes No
7. O Accessory Building
8. O Swimming Pool
9. Q Garage Detached Attached
PRESENT USE OF PROPERTY
1. O Farm/Vacant
I. Flood Zones: Yes__.___ No 4'
A. B.C.
J. Sump Pump: /)jes"—Af'—"- No
K. Geothermal Heat Pump: Yes . No_
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 comform to, all applicable laws of the State of
Indiana, and the "Zoning Ordinance of Carmel, Indiana - 1980", adopted under the authority of Acts of 1979, Public Law 178
t.et Sec. 1 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto.
00I further certify that the construction will not be used or occupied until a certificate of occupancy has been issued by the
' Department of Community Development, Carmel, Indiana.
I further certify that only kitchen, bath, laundry and floor
(� drain ar tonne to saint wer.11
�
Signature of Owner r Au orized Agent
Add ss wf -,el & 0 51 J
ity �j State Zip Phone
Sewer anacity Ilot d• e/--/_ %<—
munity Development
Received By
Inspections Needed: Drainage
noting nder Slab Temp Pole
(ED
n Met Base
Final C/
Square Footage
Permit (Sq. Footage) ............
Inspections ..................... - — -- ------
Certificate of Occupancy.......
Total.......................... --
Plan Comm. Approved (Date) -
Board of Zoning AppegsVav-
Approval (Date) SUb_—_