HomeMy WebLinkAboutOutlet Request (PDF)_Islamic Life Center-SignedINSTRUCTIONS FOR OUTLET PERMIT REQUESTS
HAMILTON COUNTY SURVEYOR'S OFFICE
KENTON C. WARD, SURVEYOR
1. Request shall be made to the Hamilton County Surveyor's Office.
2. Request shall be made on standard form only, completely filled out with:
a. Name of Drain.
b. Parcel number of property involved.
c. Project name (if none then put individual's name).
d. Name & address of owner/contractor.
e. Specifications of the outlet shall include calculations; if required, size of the
drain, length of the drain, and gradient of the drain. This office may require
more details depending on the characteristics of the outlet.
f. Plot plan showing regulated drain, private drain location, size and type of drain
material, point of connection, lot lines, buildings, physical features, platted
easements/rights-of-way, and any other information required by the Surveyor's
Office.
g. Copy of warranty deed (if property has transferred in last 60 days).
3. The form must be signed by the applicant or an agent of the applicant.
4. Checks or money orders are to be made payable to the Hamilton Coun
Treasurer. Fees are as follows:
a. Individuals $ 75.00/Outlet
b. Subdivisions, Commercial projects and Utilities $150.00/Outlet
c. Indirect (subdivision & commercial projects) $150.00/Outlet
5. Permit fee is a non-refundable review fee.
Adobe PDF Filleble Form
Revised May 2014
ON
Name of Drain:
OUTLET REQUEST
HAMILTON COUNTY SURVEYORS OFFICE
One Hamilton County Square, Suite 188
Noblesville, Indiana 46060
317-776-8495 fax: 317-776-9628
Little Eagle Creek
Parcel Number: 17-09-19-00-00-005.202
Applicant's Name:
Tim Jensen
Address: 6280 N Shadeland Ave
Indianapolis, IN 46220
Phone: 3( 17 ) 598-6647
E-mail: tjensen@theveridusgroup.com
Contractor- Installer: TBD
Address: TBD
Phone:_) TBD
Purpose of Private Tile: Stormwater detention outlet
Size of Tile:
12"
Number of Outlets:
I
Type of Tile:
Project Name: Islamic Life Center Construction Plans
Township: Clay
Property Owner: Al Salam Foundation Inc.
Property Address: 14120 Shelborne RD
Carmel 46074
Phone:( 317 ) 324-8202
E-mail: Islamiclifecenter@gmail.com
E-mail: TBD
RCP
Length of Tile:
Location of Outlet: The outlet ties into the existing structure west of the proposed site.
144 LF
Will private tile cross property not owned by the al)plicant;> It will tie into the ex. Overbrook farms str.
If yes, list parcel numbers, names and addresses of those that will be crossed:
I hereby request permission to outlet a private drain into the above mentioned regulated drain. The
construction shall conform to the standards of the County Surveyor at the point of connection with
the regulated drain. A location map of the drain is attached showing the location of the regulated
drain, private drain, point of connection, lot lines, buildings and other physical, features, and platted
easepnents and right -of This request is made as per I C. 36-9-27-17.
04/06/2021
Applicant s Signature Date
Check Title: Owner: Contractor: Engineer: Tenant: Other:
***For Office Use Only***
Permit#: Plan Project Number: Check:
Engineering Firm:
Adobe POF F11labl FForm