HomeMy WebLinkAbout0281.00 Application
~l-Clay 0 ' ..
~p II 0 ApplIcatIOn for
JI!J - Improvement Location Permit
This permit is valid only if construction is started within 120 days of issuance date; all construction must be completed (c/o issued) within 2 y.
date unless an extension of time has been officiall ranted b letter b the Director, De artment of Communi Services.
~
Permit No.
Date
Roll File
00
BUILDER
PHONE
4P S 1- 50 a-o
c7< 'Si-=P cJ50 ~ ~
FAX
OWNER
NAME~
J/
PHONE
FAX
STREET
CITY
"'ATE
ZIP
LOCATION
~.
~
SECTION
A. TYPE OF CONSTRUCTION F. TYPE OF IMPROVEME
1. W Single Family 1. ..pNew Structure
2. (0 Two Family 2(~ Addition Porch_Room_
3. 0 Multi-Family 3. 0 Remodel 0 Commercial Tenant Space
4. 0 Commercial! Industrial 4. 0 Foundation Only
5. 0 Farm ~Rasement 5. 0 Demolition
6. 0 OTHER OSlab L 6. 0 Accessory Building
(SpecifY) J\J~II-J 7. 0 Swinnning Pool
B. SEWER: 11 f1" . 8. 0 Garage Detached Attached
I.~Pnblic (Name of System f..- G. Lot Split YES _ NO 2-
2. 0 Private (Septic Tank, etc ) H. Flood Zones YES _ NO ~
C. WATER: fl l u.' () I. Sump Pump YES ~ NO_
1. ~PUbliC (NameofSysteml/tl!Yffl./!.--ti' 1. Manufactured Trusses YES r NO_
2. 0 Private (Well ) v1.J1 (' "J::;; II
D. ZONING: 5--1 K. Plumbing Contractor f71L-/,//,vC/
E. ESTIMATED COST OF ONSTRUCTION PLC--j Di.t;J-31J!/
(Excluding Land Value) -.(') <'J:) Plumbing License # ~~OCA or 0 CABO
.*********************** ********** ******........*....**......***.....********.********"..******...****...
The undersigned agrees that any construction, reconstruction, enlargement, relocation, or alteration of structure, or any change in the use of land
or slructuresrequested 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 ofI.C. 36-7 et seq, General Assembliofthe State of Indiana, and all
Acts amendatory thereto. I further certifY that only kitchen, bath, laundry, and floor draim; are connected to the sanitary sewer. I further certify
that the construction will not be used or occupied until a CrrtiJi<:JlIJ:.of.axuPIW,,"bas been issued by the Department of Community
Services, Carmel, Indiana. CALL t'I:.HMII ::n"L'U:)
ThbaJW~ctc DP 928-6447 Inspections N d~:
. Q/lI7AArFOR PI~
L L If/''' Footin nderslab R h-In eter BlUe
ature of Owner, or:1uthotjf~. A A~gent 0 ..
1 l0rctVUct~\Wt"iz. Gtl-Q0D Site Fmal CIO
riot) (phone Number) Permit (Square Footage) :3 75;)..
Sewer Capacity Allotted
Q7-00
Certificate of Occupancy:
Inspection Fees:
Plan CommissionIBZA Docket #:
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Reviewed! Approved: D