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CITY OF CARMEL
PERMIT RECEIPT
OPERATOR: slillar
COpy # 1
/
See: Twp: Rng: Sub:B62 Blk: Lot:
PARCEL ID ... .....: 1709290014016000
DATE ISSUED.......: 04/28/2006
RECEIPT #... ......: 21936
REFERENCE ID # .... 06040187
SITE ADDRESS ...... BETWEEN FORSYTH ST/ASHWORTH ST
SUBDIVISION ......: VILLAGE OF WESTCLAY
CITY .............: CARMEL
IMPACT AREA ......:
OWNER............: BRIGHT HOUSE NETWORKS
ADDRESS. .........: 3030 ROOSEVELT AVE
CITY/STATE/ZIP ...: INDIANAPOLIS, IN 46218
RECEIVED FROM ....:
CONTRACTOR .......:
COMPANY... .......:
ADDRESS.... ......:
CITY/STATE/ZIP ...:
TELEPHONE.... .....
ADAM MYETICH
LIC # ETELEPLA
TELECOM PLACEMENT, INC
15405 LITTLE EAGLE CREEK AVE
ZIONSVILLE, IN 46077
(317) 752-7758
ICIIELEMTR FLAT RATE
TOTAL PERMIT :
METHOD OF PAYMENT
1. 00
AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ---------- ---------- ----------
100 00 0.00 100 00 O. 00
---------- ---------- ---------- ----------
100 .00 O. 00 100 .00 O. 00
FEE ID UNIT QUANTITY
AMOUNT
NUMBER
CASH
TOTAL RECEIPT :
100.00
------------
------------
100.00
CITY OF CARMEL / CLAY TOWNSHIP
IMPROVEMENT LOCATION PERMIT APPLICATION
For: ELECTRICAL INSPECTION
Permit #: 06040187
Date: 04/28/2006
PARCEL ID #: 1709290014016000
LOT & SUBDIVISION: VILLAGE OF WESTCLAY
ADDRESS OF CONSTRUCTION: BETWEEN FORSYTH ST/ASHWORTH ST CARMEL, IN 46032
Township?: Zoning: Flood Zone: Lot Split:
PROPERTY OWNER INFORMATION:
Name: BRIGHT HOUSE NETWORKS
Ph. #: 3177527758 Fax #: 3177694645
Street Address: 3030 ROOSEVELT AVE INDIANAPOLIS, IN 46218
CONTRACTOR INFORMATION:
Name: TELECOM PLACEMENT, INC
Ph. #: (317) 752-7758 Fax #: (317) 769-4645 Email:
Street Address: 15405 LITTLE EAGLE CREEK AVE ZIONSVILLE, IN 46077
APPLICANT INFORMATION:
First Name: ADAM
Ph. #: 317-752-7758
Street Address: 15405
Last Name: MYETICH
Fax #:
LITTLE EAGLE CR ZIONSVILLE 46077
46077
PERMIT TYPE: MELECTRIC ; ELECTRICAL PERMIT/INSPECTION
Residential or Commercial: COM
Service Upgrade: N
Panel Board Upgrade: N
Current Amperage:
New Meter Service: Y
Upgrade Amperage:
Row Signal: N
Number of New Circuits: Number of New Meters: 1
Relocated Structure Connection: N Moving Service (Overhead to Underground): N
Alteration, Addition, Remodel, or Repair to Existing Distribution System: N
Special Notes/Conditions:
ELECTRICAL METER BASE FOR BRIGHTHOUSE NETWORKS
IN THE MIDDLE OF THE PARCEL THAT IS BETWEEN
FORSYTH ST AND ASHWORTH ST @ VILLAGE OF WEST CLAY
NEAR RONALD REAGAN GREEN. ."SEE MAP IN FILE. . NO NOTES.
This permit is valid only if construction commences within one (1) year of the date of issuance of the State Commercial Design Release.
All construction must be completed (C/O issued) within two (2) years of the issuance date.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of
land or structures requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning
Ordinance of Carmcllndiana -1993" (Z~2S9) and amendments, adopted under authority of LC 36-7 et seq, General Assembly of the State of
Indiana, and all Acts amendatory thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. 1
further certify that the construction will not be used or occupied until a Certi{jc;lte oI Occupancy has been issued by the Department of
Community Services, Carmel, Indiana.
APPLICANT NAME: ADAM
FEES:
CII ELECTRICAL/METERB.
MYETICH
100.00