HomeMy WebLinkAbout0652.02 Application r irmel/Clay
Township Application for Permit No.
. 12‘)4)...2.
1 opDate
ULo
-Hold#: ((nnc�I ''1 Improvement Location Permit
Roll File
This permit is valid only if construction is started within 180 days of the date of issuance for residential construction;and for commercial projects,within one(1)
year of the date of issuance of the State Commercial Design Release. All construction must be completed(c/o issued)within 2 years of the issuance date.
NAME PHONE F
BUILDER t{omP � Q ti5.a)30Pi-Aa-a3eq
STREET CITY • STATE ZIP
C(PQ L1 3L OD 1 r\O 6 Jig Lita;
TENANT NAME RELEASED FOR CONSTRUCTION
(If applicable) Subject to compliance with all Regulations
NAME PHONE or State and Lane Code!
OWNER Cerrt i+O(Y1.3 0 I 5'
OFCARMELICCA i .NP
STREET CITY INDIA TE ZIP ri
LOT SUB IVISION � _
LOCATION R�✓1;1 I e �Je______4-1
-III - 4 2002
ADDRESS OF CONSTRUCTION v"�
1Nc9)0\ 5kRe1s Oid9F. iR ____ _._
A. TYPE F CONSTRUCTION Do plaps.include a porch? F. TYPE F INtPROVEMEN e li. ! 4qr V e
1. Single Family 0 Yes 0 No 1. New Structure-- —r '��
2. 0 Two Family 2. 0 Addition: Porch 'oom i��1 Ill 1
3. 0 Multi-Family Type of Foundation 3. 0 Remodel 0 Commerci. enant Space
4. 0 Commercial/Industrial El rawlspace 4. 0 Foundation Only
5. ❑ OTHER !a' Basement 5. 0 Demolition
(Specify) 0 Slab 6. 0 Accessory Building
B. SEWEIjr. 7. 0 Garage Detached Attached
1. a Public (Name of system Carmti ) /
2. 0 Private(County permit# ) G. Lot Split YES NO
C. WAT : H. Flood Zones YES NO V--
1. Public (Name of system r{�;(-rne ( ) I. Sump Pump Y �.- NO
2. 0 Private(County permit# ) J. Manufactured Trusses S NO
D. ZONING: C)-1 K. Plumbing Contractor AR S
E. ESTIMATED COST OF CONST 1RUCTI C IRC Plumbing Code: 0 umber's
(Excluding Land Value) I'-1 b j I k; Indiana Plumbing Code: 011 License#: Pi C OD ) 7 -
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I,the undersigned,agree that any construction,reconstruction,enlargement,relocation,or alteration of a 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
Cert'icate of Occupanc has been issued by the De artment of Community Services,Carmel,Indiana.
Ja,ntc
CALL PERMITS P __ INSPECTIONS N EDED:
_____4---
a Signature of Owner or Authorized Agent DP 928_64 k ootin nder Slab R ugh-In ' eter Bse
arn1 Otaaneir QIs, to For Pick-Up
Sites lam"
(Print) (Phone Number) Sq.Ft. e����
. Filing Fees: 3
6(0
E-Mail:lA e 'nor e centexnurne5.Wrn Inspection Fees: 35
Cert. of Occupancy: t?'
P.R.I.F.: �J
B Plan ommissionZA/BPW Docket#'s; TAC Date(s)
TOT r
II I --%V i‘v 4/v
Reviewed/Approved: Dept. of Community Services Fee Received by S:Permits/Forms/ILP2-02