HomeMy WebLinkAbout04120073 Application
~ellClay
Township
Application for
Improvement Location Permit
PermitNo. OI/,9.ptJ73
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 conunercial projects, within one (1)
ear of the date of issuance of the State Conunercial Desi Release. All construction must be com leted c/o issued within 2 ears of the issuanc~ date.
PHONE
FAX
BUILDER
.3 0 ~4-?
STATE ZIP
Y7,4-&,G86
fl
We It e PHONg.f- (" -6 C. /,
FAX
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NAME
PROPERTY
OWNER
STREET
/0 ~os N: f!o I/.
CITY
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STATE
ZIP
LOCATION
..:z S- 8
..B 1<> c ,t.
2.
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I
LOT
SUBDIVISION
ADDRESS OF CONSTRUCTION
. At/e,
4-&> -z...R 0
A. TYPE OF CONSTRUCTION Do plans inclnde a porch? F.
1. ~le Family 0 Yes lX"No 1. 0
2. 0 Two Family 2. 0
3. 0 Multi-Family Type of Foundation 3. 0
4. 0 Commercial/Industrial 0 Crawlspace 4. .0
5~ OTHER 1I1l NYlI1 B Basement (Walkout y.Ql::l 5. )(
(Specify)~ 0 Slab 6. 0
B. S WER: --/IJ? 4. 7. 0
1. ~ Public (Name of system 0/7" ;:e,y d j',
2. 0 Private (County permit # ) G. Lot Split
C. WATER: H. Flood Zones
1. .l!ll' Public (Name of system Z VI ~/5 IJ -? ~ {l,d. Sump Pump
2. 0 Private (County permit # ) J. Manufactured Trusses
D. ZONING: .~." \ K. Plumbing Contractor
E. ESTIMATED C ST 0; CONST ON IRC Plumbing Code:
(Excluding Land Value) Indiana Plumbing Code:
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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 ofCarrnel Indiana - 1993"
(2-289) and amendments, adopted under authority of I.c. 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 samtary-se.wer. I further certify that the construction will not be used or occupied until a
Certificate of. ccupancy has been issued by the epartmeirt~f Community ervices, Carmel, Indiana.
, ;/ ~.~ '*'" VI. 4 INSPECTIONS NEEDED:
Signature ofOwn~zed Agent ,~ . J .:r flpper F ting Lowe tiug Bondi G undin
21r 4j(~'f UI'~
rint)
~" 6.-(;7 ( 1/'
(Phone Number)
JA5. aD
5"";< . 0 (J
7.5". () 0
Filing Fees:
Base Inspections:
.cfl~-~t!::J':
P.R.I.F.:
# Charged Re~
Reviews
)<JE-Mail:
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Plan C07i.;,.!1fB ~
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~.- (-.
Review~APprd;,e Dept. of Community Services
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Additional Fees