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CITY OF CARMEL
PERMIT RECEIPT
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OPERATOR: vdolan
COPY # 1
See: Twp: Rng: Sub: Blk: Lot:
PARCEL ID ........: ELECTRICAL
DATE ISSUED.......: 07/20/2006
RECEIPT #.........: 22713
REFERENCE ID # .... 06070117
SITE ADDRESS. ..... 12621 SPRINGMILL RD
SUBDIVISION...... :
CITY .............: CARMEL
IMPACT AREA ......:
OWNER ............: BRIGHTHOUSE NETWORK
ADDRESS..........: 3030 ROSSEVELT AN
CITY/STATE/ZIP ...: INDIANAPOLIS, IN 46218
RECEIVED FROM ....:
CONTRACTOR .......:
COMPANy.......... :
ADDRESS ..........:
CITY/STATE/ZIP ...:
TELEPHONE .........
TELECOM PLACEMENT
LIC # ETELEPLA
TELECOM PLACEMENT, INC
15405 LITTLE EAGLE CREEK AVE
ZIONSVILLE, IN 46077
(317) 752-7758
ICIIELEMTR FLAT RATE
TOTAL PERMIT :
1. 00
AMOUNT PD-TO-DT THIS REC NEW BAL
--~~------ -----~---- ----~-~--- -----~----
100.00 0.00 100. 00 O. 00
---------- ---------- ---------- ----------
100.00 0.00 100 .00 0 .00
FEE ID UNIT QUANTITY
CITY OF CARMEL / CLAY TOWNSHIP
IMPROVEMENT LOCATION PERMIT APPLICATION
For: ELECTRICAL INSPECTION
Permit #: 06070117
Date: 07/20/2006
PARCEL ID #: ELECTRICAL
LOT & SUBDIVISION:
ADDRESS OF CONSTRUCTION:
Township?: Zoning:
12621 SPRINGMILL RD CARMEL, IN
Flood Zone: Lot Split:
PROPERTY OWNER INFORMATION:
Name: BRIGHTHOUSE NE1WORK
Ph. #: 3176329077 Fax #:
Street Address: 3030 ROSSEVEL T AN 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. #; 3176329077
Street Address: 12621
Last Name: MYETICH
Fax #:
SPRINGMILL
PERMIT TYPE: MELECTRIC ; ELECTRICAL PERMIT/INSPECTION
Residential or Commercial: COM
Service Upgrade: Current Amperage:
Panel Board Upgrade: New Meter Service: Y
Number of New Circuits: Number of New Meters:
Relocated Structure Connection: Moving Service (Overhead to Underground):
Alteration, Addition, Remodel, or Repair to Existing Distribution System:
Upgrade Amperage:
Row Signal:
Special Notes/Conditions:
ELECTRICAL INSPECTION FOR POWER SUPPLY CABINET FOR
BRIGHTHOUSE CABLE, POLE #8386180, MAP INCLUDED
IN FILE, ADAM 752-1094 . 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 Carmel Indiana - 1993" (Z~ 289) 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 Ooor drains are connected to the sanitary sewer. I
further certify that the construction will not be used or occupied until a Certificate of Occupancy has been issued by the Department of
Community Services, Carmel, Indiana.
APPLICANT NAME: ADAM
FEES:
CII ELECTRICAL/METERB.
MYETICH
100.00