HomeMy WebLinkAboutOutlet Permit Request 03-16-22OUTLET REQUEST
FIAMILTON COUNTY SURVEYORS OFFICE
One Hamilton County Square, Suite 188
Noblesville, Indiana 46060
317-776-8495 fax: 317-776-9628
Williams Creek
Name of Drain:
17-09-34-00-00-019.000 &
Parcel Number: 17-09-34-00-00-021.000
Revised May 2014
Jackson's Grant Village,
Project Names Section 2
Township: Clay
ApplicanYS Name Iackson's Grant Real Estate Co., LLCproperty Owner Jackson's Grant Real Estate Co., LLC
Address: 13578 East 131 st Street, Suite 200 Property Address•520 West 116th Street
Fishers, Indiana 46037 Carmel, Indiana 46032
Phone: 3{ 17) 770.1815 Phone:)
E-mail: dwagner@republicdev.com E-mail:
Contractor- Installer: N/A
Address:
Phone:( E-mail•
Purpose of Private Tile: Indirect outlet for subdivision
Size of Tile: Type of Tile: Length of Tile:
Number of Outlets: 1
Location of outlet: Northwest portion of parcel
Will private the cross property not owned by the applicant? No
If yes, list parcel numbers, names and addresses of those that will be crossed:
I hereby request permission to outlet a rivate drain into the above mentioned regulated drain. The
consiruction 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
drat , rivate drain, point of connection, lot lines, buildings and other physical features, and platted
�em . is and_ rig -wa� T request is made as per I. 1 , 2027-17.
� 4 March 16, 2022
ApplicantYSignature "
Check Title: Owner: Contractor:
Date
Engineer: Tenant: Other:
� L
ilankrojectliumber: Check:
Engineering Firm:
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