HomeMy WebLinkAbout06040010 Application
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Swimming Pool/Spa \ \ u
Permit Application \ /loP?' - It L()()a
ar.rolQrmel/ (Jay To
,
OWNER:
o ~D
,
~UIIDER:
City State
AII\JFIUO :T~
Phone
Fax
~17 T3"/-1I
Zip
NIDIll
Phone
K R..ot4-
Fall
I<er
3'7-
City
Oar
-950.3
Slate
-..J
Zip
4-foo.3~
ZoDiD&
Lot No.
Subdivision
Seetlon
Cop8trUction
Location:
City
State
Zip
2-
EttimIIed Cost of COIlllU1lC:lion:
(pool one! Deck) I 1-r:J" MtJ-
Pool JIlIIIed: Y/N IT]
Flood Zone: Y/N [l[]
Auto filler: YfN mJ
TOTAL SQ, FOOTAGE:
(Pool and Deck) I '?CXJ h
RETYPE:
I ~ j,
PoolC<mr: Y/N
Septic System:Y/N 10
Sump Pump: Y/N
(if yes, indicate drainqe on
For Commerdal Pools. state
Clan of pool bein<< built:
1-
Commercial Pools - provide
sr.~ Releue No.:
S.feI)' realll... (lallud1Dl pool eovan> BIaaII IOmply with lDdIau 8m.Daa Pool CodtB 615 lAC 10.+17 .Safaty ....tu...... EIHBB I)'ItIDIB
tII.tlavolft BtllpI with lbno' or 810", ria.... wW reqalre . baadnlllllJlalled to spedtlcatloa. of lb. Iadlan. Pool Cod..
Tho a_ped...... tIlaIany COlI...._. _olNoIIon. -"'-1, roIocodon '" aItIlOIlaII of_ or any .ban.. In lb. uoo of lend or .lNllIlIra roqulllld
bythll1Jlll1loltlon, wllI..,.,.1y with IIIlIIIClIlflInn to,oIIlJlPlll:ablo IIWS oflhe SlIte oflndl1l11 (forraldonlWpooll, d7S lAC ZQ..l.l-I throusltZQ..1.l-22111l16?51AC
IO-4-11I\lllIIJIl ZO-4-Z7; tor OOlI1IMIOlII pool., 6'7S lAC 2()..1.l-1 thrauJIt Z0.3-9) ud the l""linl Ordfnln.. or: C.....I.lndion. - I !liD, .doplOd lIftdor the authority of
Acta or 1979, PubUc Law 171, sec. I, el. Seq.t 00nera1 Aaembly ofthc Stall of Indiana, and an Acltlll"lllndltory U\er'l1o.
NOTEI' /fpool COIIItruclioll requires tJCCtsa to property through a right.ofway, /lOt call1a/llmg IlII <abll8hBd drIvfwa.Y. th'DJIP"cllIIl
"""t galll APPrvva/a throueh the City of Ctmllel Ellgilleering Dept. (571.2441) or lIIe Hamilton Coultly H!glrwt1y Dept. (773- 7170),
(W/Itc1lever II applicable.) ,
I '
I hereby certify that the improvement / swimmins pool will not be used or occupied unlil a Certificate of Occupancy h.. been iSlued by ,
the ~partmenl of Community Services, Cannel, Indiana.
c-_ ~ION~OUI~.n.
~nntlinro ding - Final ' 7 W
FEES: Permit Fee: L/3 J () 0
711-00
l1\.li11111 '(yJ /./0 1.h'J - -{Jn$ L)f:. k...,J I
~~er or Authorized Agent 7 ,j 3 I
i /.." -: $1'9,1-
(Print) S b . 'fr~T/ON
BZA Approval, YjN U Ject to compliance with ali regulations
of State anrllocaJ Codes.
DPt4i OF COMMUNITY SERVICES
CITY OF CARMEL! CLAY TOWNSHIP
'Ii Sri.. NA Fee
') 3. -)0
. :SO
v
Reviewed I
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