HomeMy WebLinkAbout04120051 Application
Carmel/Clay i . l~ 4
Towm,hip Application for lY Permit NoiJ /:2 0 () t) I
! L L'P,' Date
'-'Hold'#: mprovement ocation ermlt Roll File O<fl :J..L}1)t.f3
ThIS perrrut is vahd only if construction IS started withm 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.
FAX
BillLDER -6 5- ;<.3
STATE ZIP
;)
TENANT NAME
Ifa Iicahle)
PHONE FAX
OWNER 's.
STREET CITY STATE ZIP
~
SECTION
LOCATION ;).
A. TYPE OF CONSTRUCTION Do ~ns mclnde a porch? TYPE OF IMPROVEMENT
I. ~le Family ~hs EI No I. &J.",Structure
2. 0 Two Family 2. 0 Addition: Porch_Room
3. 0 Multi-Family Type of Foundation 3. 0 Remodel 0 Commercial Tenant Space
4. 0 Commercial! Industrial 0 Crawlspace 4. 0 Foundation Only
5. 0 OTHER ~ Hasement ,; 5. 0 Demolition
(SpecifY) 0 Slab nD WQI JI\ ()() to. 0 Accessory Building
B. SEWER: () 7. 0 Garage Detached
I. ~iIblic (Nameofsystem( h,rnt-P/ Dh}, lies
2. 0 Private (County permit # ) G. Lot Split YES NO ~
C W AJER: 17 I \ I J H. Flood Zones YFQ -----::::-NO V-
I. ~blic (Name of system lIeN Mf2 I L/f'I/, n e::::, L Sump PU!!'l', YES ~ NO_
2. 0 private(Countype/rmit# ) ~~~ueI'~ Tru~ YES ~O--==-
D. ZONING: '2> ~ _ . \f!.O Il'O? ~~\\1\'IDt>i8G~~ractor tIC/hi t1:! if ~/1 "3 -I r)c.
E. 'ESTIMATED COST 1. CONSTRU~~~ 5~(\\\l\\llJ'C~od!\C~n~e: 0 PIUlnber's
(Exc1udmg Land Value J.oQ, 'i51~'e~~ ~\\;\Il (\l\n"~,J~rii~~de:~cense #: (J f 1{'XYy) It<> )
*********************** ********************~~**~~~~~*fl~~~~~;;***~**************************
I, th~ undersign,ed, a~ee t~at ~y constructi?n, recoR~91l~~\elb~~: or alteration ?fa structure, or ~y ch~ge in the use ofland ~r structures
requested by thIS apphcatlOn wIll comply wIth, and.c _ ~a~nc~w~'Wt'ke State of Indiana, and the "Zomng Ordmance of Carmel IndIana - 1993"
(2-289) and amendments, adopted under authority .. 36-7 et seq, Geb1:rni"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
rtificate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana. :'
Attached
?<~ INSPECTIO~EDEt~
LV II b ~6lUnder Slab ugh- . eter Bas
. ~i' t Q... Site Final 00 -7
~U'IICP Vn?JA-nO()H'l 576-0(3mK~3'6 1-- S F lAOS
(Print) (Phone Number) q. t f4l
Filing Fees:
Base Inspections:
Cert of Occupancy:
/
E-Maty;}v1IC'Q. clei)4fYX),c.~flll t-€. C rlV'}
P.R.LF.:
Plan CommissionlBZA/BPW Docket #'s; TAC Date(s)
U/ld NJJj
Reviewed/Approved: Dept of Community Services
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