HomeMy WebLinkAbout07040220 Application
City of Carmel/ Clay -Township 6704 D 221)
APPLICATION FOR ELECTRICAL INSPECTION
NAME
PHONE
FAX
City
'3 /7 ~ - &;i-{)(Jt1
State Zip
q)NTRACTOR Eu;,;:r'-/L-
INFORMATION: Street Address
NAME
~~~"''V'a vi'1 -pvtX-
CONTACf PHONE:
1'Jt;7?-t
APPLICANT
INFORMATION:
,t: ""/ C, 4, ~f
Property Owner
(or agent) ?'
Contractor
Representative
/
OR
TYPE of WORK:
- RESIDENTIA~:
_. - -. 'COMMERCIAl: X'd
PROPERTY OWNER NAME{S):
PHONE:
PROPERTY
OWNER
INFORMATION:
$15 c.-
STREET ADDRESS:
City
State
ZIp
::z:;u 04/
City
STREIT ADDRESS (INSPEcnON LOCATION):
State
'-/I.--.t--
Zip
INSPECTION
, INFORMATION:
2- /;:r. I" ~ $-r,,..,,7'
DATE OF INSPE~ _ ;;! 0./ .
TYPE-OF IMPROVEMENT:
(,.",-"'7- t.- ",~@A'''''-
TIME OF INSPECTION:
AlAi //'/
MOVING SERVICE FROM OVERHEAD
TO UNDERGROUND?
o UPGRADE SERVICE: From
to
DYES
o NO
o UPGRADE PANEL BOARD(S)
o ADDmON, ALTERATION, R.EMODEL, or REPAIR TO
AN EXISTING ELECTRICAL DISTRIBUION SYSTEM
Number of NEW CIRCUITS:
Number of METERS: ,
o NEW METER SERVICE (Le. Fountain in pond;
Subdivision street or signage lighting; Installation of
new utility services for an area)
I CERTIFY THAT THE INFORMATION CONTAINED
ON THIS FORM IS COMPLETE AND ACCURATE.
-~d~/0~
Signature
o ROW SIGNAL, SENSOR, MONITOR (Le. Traffic Light)
o CONNECTION or RECONNECTION TO A RELOCATED
STRUCTURE
'?,bh,I (. ,4" 7'/
PRINT
0747
DATE ' -
,
COMMENTS or FURTHER LOCATION CLARIFICATION: (Please attach maD of insDection location)
/%/u..e ~~/..._r;' C:.:.v~ T 0/ C,,LLer;1>"-. .#1./.....
/
FEES: $ 100.00 for Commercial Inspections; $ 55.50 for Residential Inspections
S:Permlts/Forms/Electrlcal Application Apr 2006
Driving Directions from 1 Civic Sq, Carmel, IN to Carmel, IN
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Page 1 0~2
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entire map, try clicking the "Printer-Friendly" link at the top of your results page.
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11II 1 Civic Sq
Carmel, IN 46032-2584, US
all Carmel, IN 46033, US
Total Est. Time:
9 minutes
Maneuvers
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Total Est. Distance:
3.39 miles
Distance
1: Start out going EAST on CIVIC SQ toward GRADLE DR.
2: Turn LEFT onto GRADLE DR.
<0.1 miles
<0.1 miles
3: Turn LEFT onto S RANGE LINE RD.
0.3 miles
4: Turn RIGHT onto E 126TH ST.
0.7 miles
5: Turn LEFT onto N KEYSTONE AVE / IN-431 N.
0.4 miles
6: Turn RIGHT onto E MAIN ST.
1.4 miles
7: Turn RIGHT onto HARRISON DR.
0.1 miles
8: Turn RIGHT onto RILEY MEWS.
<0.1 miles
9: End at Carmel, IN 46033, US
Total Est. Time: 9 minutes
Total Est. Distance: 3.39 miles
http://www.mapquest.com/direclions/main.adp?go= I &do=nw&nnm= 1 &un=m& 1 rc=L I A... 4/27/2007
Driving Directions from I Civic Sq, Carmel, IN to Carmel, IN
Page 2 of2
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entire map, try clicking the "Printer-Friendly" link at the top of your results page.
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All right~.--,::e_s_erved_. Use Subject to---.!"lcense/CoRYfl9ill
These directions are informational only. No representation is made or warranty given as to their content, road conditions or
route usability or expeditiousness. User assumes all risk of use. MapQuest and its suppliers assume no responsibility for any
loss or delay resulting from such use.
http://www.mapquest.com/directions/main.adp?go= l&do=nw&rmm= 1 &un=m& 1 rc=L I A... 4/27/2007