HomeMy WebLinkAbout04120072 Application
ti
\
Application for ( I \ L, to.. ~er;mt NoQ4 J.? 007;J-
Improvement Location PermlYV ~:~ Fil~ 1:1.0070
This pennit is valid only if construction is started within 180 days of the date of issuance for residential construction; and for commercial projects, within one (I)
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.
NAME
PHONE
FAX
BUILDER
~()'\Go
2~qqco
2.D~QL\ ~ 0
CITY
STATE
ZIP
is
wo
PROPERTY
OWNER
NAME
.:L. +-~()1eo
PHONE
FAX
LOT
SUBDIVISION ~<\.r~
~\"'il~e." C~
::IPd
o <::::,q WO
I
STATE ZIP '
. I
'-lloC '0
Z f.:::,qqCD
CITY
SECTION
SQUARE
A, TYPE OF CONSTRUCTION
1. 'lilt Single Family
2. 0 Two Family
3. 0 Multi-Family Type of Foundation
4. 0 Commercial/Industrial l! Crawlspace
5, 0 OTHER ~ Basement (Walkout, yGl
(Specify) ~ SlabL
R SEWER:
L ~Public (Name of system C'rlt.wD )
2. 0 Private (County permit # ) G. Lot Split YES NO -t.
C. WATER: ,- v H. Flood Zones YES - NOI::
L ;/OLJ'ublic (NameofsystemC'.oY'n)flD /}.; ~~8.~~pump YES I NO_
2. 0 Private (County permit # ) 'SY ~B/@€t(.mut~#'bTrusses YES + NO
D. WNING: ~- \ i1E Pl~~W<<~~N~ ~. S~--rh
E. ESTIMATED COST OF CO.NSTRUCTION~ tJltY~bfl~.CJ ?Ilf'd.r~:h~' ra ~~'s
(Exc1udingLandValue) ::z..20,'()~, "'l>ii~ail' 'lJNrrnJi,. Li~-;;~1e#: \O\Tl~
******************************************************************~\ ~ */t;;;ifi ~~~*~***************
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or al~Rf~c7t~lL41~~ge in the use ofland or structures
requested by this application wilt comply with, and conform to, all applicable laws of the State- .;rfuidi~ and the ';td~~lJhance of Carmel Indiana - 1993"
(Z-289) and amendments, adopted under authority ofLe. 36-7 et seq, General Assembly of the State oflndiana, 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
Cert. lcate of Occupancy, has been issued by the Department of Community Services, Carmel, Indiana.
Do Rlans include a porch?
)(J Yes 0 No
F. TYPE OF
l.~Ne
2. 0 Add
3. 0 Rem
4. 0 Foun on
5. 0 Demo .tion
6. 0 Acces Ul ding
7. 0 Garage Detached
LOCATION
~s
4..
ADDRESS OF CONSTRUCTION
\~~
cr
Attached
Filing Fees:
Base Inspections:
:L
~r:~c.. CDroC1J
(Print) (Phone Number)
L.e;\.,f'
E-Mail:Or-o Dr r--b-- @ nlT ~(l!YIth . C (IrYJ
# Charged Re-
Reviews
/ ?-.5" J)()
Additional F:/
P.R.I.F.:
Reviewed/Approved: Dept. of Community Services
S:Permits/Forms/ILP3-04