HomeMy WebLinkAbout06030057-Application
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BUILDER:
Name
OWNER: 13 l-U NI<-
J \) (;),Iene...
Co~struction
:Location:
StIMt Addrell
1d.-1;)..0 INdCJ 0 S. f\y PI-A ec=-
Lat No. Subdlvlllon
q::l ,^" N t>':t'o I NT~
Addrea of CoIIIlr\ICdon
\Noo 13 <;
,
'tNo.:
{)3CJO 5
Fax
Fax
41-
--
o
State
IN.
ZIp
4bo33
ZoDiDg
~--
Section
City State
ell Q.m~.L 1/'--\.
Zip
Lf6033
TOTALSQ. FOOTAGE:
(Pool and Declcl I '2. Z 'Z. 4
RETYPE:
I 'JC
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Ell eolt of ConoInx:Iion:
(Pool an. d Deck) I 52.
,000
Pool ~eaJed: Y/N [TI
Flood Zone: Y/N c:::tLJ
AutoPllw: Y/N IT]
I
Pool CoYer: , Y/N
i
Septic S~m:Y/N
Sump Pump: Y/N
(if ",,", indicate drainage on
For Commercial Paolo, otate
CIaoo of pool being built:
I -
Commercial Paolo - provide
Stale Deoian Releue No.:
I .~
I
s.fetJ '..Ill.... (hldlldlill peal _11'1) ....11 amply wltb lad!au SwIDlmlll1 Pool Codll 615 lAC 10.+27 "Sltel)' ,..Ill""". Ear" ll'oteDII
that IlIvolveltlpl wItb III..... or more I1len will requI... a budnlllllltalled to .pedflcatlolll of III, IIIdlalla PoGI Code.
Tbe 1IIIdonIpod....... tblllllf .on....oll... ......1IlrUCli... ..Iaftemon~ relocation or llloraII... at ItnIctun. or IlIf........ In the.1e orland or - nqUOltecl
1Il'1ht11PP1iald1ll, wID .amp\),wI.IIl.IIld.Ocaftlna... "". 1I11PP11....... ...I."..M.. .rthe StlIP..vt: ~Wv.(tlIr1Olldandll pooIa, 675 lAC 20-1.1.1 \MluJIIjil.n .ncI615lAC
IO+t t11rcq1120-4.27: tlIr...........1I paola, 675 lAC 2O-~.H,~,,,,;~)iiicI1dio-1drI1II 0nIlnIIIc. atCarrneI,lrIdllll. -1980, ad tho .uthorily or
1\011 at 1979, Public Law 178, k:: 1,lll.:~~,~\~If~~;~\'{~~1 AoIa ..-cI.tmf-'
NOTBr (fptJOl_tl'NCllti"'ieiJU.~acc.~:1D;p;ojierlYJ!I--~(j;rIg1rl-of-Wtly,lIOlca way. the applica",
",,,,,'...111 llJ'Pr'Ow/, tI"",;pl'iM'CiiJ!;fl~el,E~t!j~i~(11l!l&1) . ighWtJ,)l Dept (773.7770).
(W/IIcIa-" applIcable.) .~. ~ ('f\\'~'~\U\'" . 'i "'NSI-II
'. in__IC'I;.2T'k...,;~'~. .,.....i\.'..10vv . ., . . .' .
I hereby eenify that the JIDIlIO"'lIDenl t 1~.p<>Ol WOInot be uoed or occupied unlila Cettificate of Occupancy has been ...ued by
the ~pertment of ColllDl'!l}\tfSefVlte.; .0ltDie1.,!J1.di~ f'.
h1l~ ~L~ i
~ 0 er or Authorized Agent .., I
. 317- 11'-I-'3'f9.5
.Lk1i1..RiD ~ IY\ 1 \::.1;:: L ~
(PrInt) (Phone No.)
BZAApproval: Y/N D
BZA Docket No.: Dale,
(? -y~ q !1 )~, .0-v" 0 -N-o(-,
ReYlewed I Ai>Jlri!ved B)'l Dept. of Communi., SeniceI
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by:
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