HomeMy WebLinkAbout04120026 Application
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Application for
Improvement Location Permit
Permit No. o'l().002(P
Date
Roll File
This permit is valid only if construction is started within 180 days of the date of issuance for residential construction; and for commercial projects. within one (1)
ear of the date of issuance of the State Commercial Desi Release. All construction must be com leted c/o issued) within 2 ears of the issuance date:
Hold#:
NAME
PHONE
BUILDER
L
STREET
(/0 f p.
CITY
TENANT NAME
Ifa Iieable)
NAME
PHONE
OWNER
CL
STREET
CITY
FAX
STATE
ZIP
FAX
S L.L.(..
" '5" t>l:J "0 ~- 5'1
STATE
ZIP
r;
('OL.I ( 2.. r>
LEASEDsE<ml
SUbject to campi' CONSTRUCTION
lance w'th I .
DEPT OF an local COdes.
CITY OF C COMMUNITY SERVICES
HIP
LOT SUBDIVISION
LII
LOCATION
CLA
ADDRESS OF CONSTRUCTION
I Lf Z
TYPE OF CONSTRUCTION
1. 0 Single Family
2. 0 Two Family
3. 0 Multi-Family Type of Foundation
4. ~. Commercial! Industrial 0 Crawlspace
5. bOTHER 0 Basement
(Specify) 1)1' Slab
B. SEWER: A
1. )c1' Public (Name of system CJ\J'vrl..t.~
2. 0 Private (County permit # i
C. WATER:
1. J8f' Public (Name ofsystem~ ~
2. 0 Private (County permit #
A.
Do plans include a porch?
DYes (l/fNo
F. TYPE OF IMPROVE~ANA
1. Jii New Structure
2. 0 Addition: Porch Room
- -
3. 0 Remodel 0 Commercial Tenant Space
4. 0 Foundation Only
5. 0 Demolition
6. 0 Accessory Building
7. 0 Garage Detached
Attached
G.
H.
I.
J.
YES _ NO-1-
YES NO
YES == NO-=:X=
YES _ NO~
Lot Split
Flood Zones
Sump Pump
Manufactured Trusses
D. ZONING: pun K. Plumbing Contractor [()W4I7Y1 '5 /YItLfJA.A/icAt..
E. ESTIMATED COST Of CONSTRUCTION IRC Plumbing Code: 0 Plumber's
(Excluding Land Valuel-1i I. 3 IVI) L Indiana Plumbing Code: KY License #: 'g70 106
************************************************************************************'***********************
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration ofa structure, or any change in the use ofland or structures
requested by this "application will comply with, and conform to, all applicable laws of the State ofIndiana, and the "Zoning Ordinance of Cannel Indiana - 1993"
(2-289) and amendments, adopted under authority of I.e. 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. 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.
7l!JJ ~ ~
Signature of Owner or Authorized Agent
,
/1'/; r~'H/ f) S'~""1C\"'S
(Print)
e., /</.
/I~
8/7) ':;75- -'slOe:,
(Phone Number)
E-Mail: .-11 -Sf .11V1eo1.J @ fa", +1.. . Yl e-l-
1'1<{-OZ.OP ; 1(01-03 of
Plan CommissionlBZA/BPW Docket #'s; T AC Date(s)
~~N\tkA~
Reviewed! Approved: Dept. of Community Services
Site Fina C! Ll
u'(), 11. J;) Sq.Ft. 3?-,33,
S'(PI. () () /
Cert. of Occupancy: / tJ () ~ f) CJ
P.R.I.F.: if;~
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.tee ReceIved b}L.- - S:PennitslForms/ILPS-02
Filing Fees:
Base Inspections: