HomeMy WebLinkAbout07060120 Application
City of Carmel/ Clay Township i
APPLICATION FOR ELECTRICAL INSPECTION
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NAME
CONTRACTOR
INFORMATION:
..."'/ (.~/ /
Street Address
::z 56d e. 5:J<<,{"p
NAME
APPLICANT C,Chhr
INFORMATION: Property Owner
(or agent)
r
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TYPE of WORK:
RESIDENTIAL:
PROPERlY OWNER NAME(S}:
PROPERTY
OWNER
INFORMATION:
<; ~
STREET ADDRESS:
/;:{77 U/. 'JU ::;-/;."r/
STREET ADDRESS (INSPEmoN LOCATION):
INSPECTION
INFORMATION:
TYPE OF IMPR
o UPGRADE SERVICE: From
to
o UPGRADE PANEL BOARD(S)
o ADDmON, ALTERATION, REMODEL, or REPAIR TO
AN EXISTING ELECTRICAL DISTRIBUION SYSTEM
-$... NEW METER SERVICE (i.e. Fountain in pond;
Subdivision street.or signage iighting; Instailation of
new utiiity services for an area)
o ROW SIGNAL, SENSOR, MONITOR (Le. Traffic Light)
o CONNECf10N or RECONNECf10N TO A RELOCATED
STRUCTURE
COMMENTS or FURTHER LOCATION CLARIFICATION:
80/,-,<, /',;/7,('/"",,-/
PHONE
FAX
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City
State
'"
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CONTACT PHONE:
OR
317 {:,;'-'1-/
Contractor L,-a/<L. ~/r'-~
Representative
COMMERCIAL: X
PHONE:
City State Zip'
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City State Zip
:Z:;~41/v-",-"
TIME OF INSPECf10N:
A--v ~.
. MOVING SERVICE FROM OVERHEAD
TO UNDERGROUND?
DYES
o NO
Number of NEW CIRCUITS:
Number of METERS: /
I CERTIFY THAT THE INFORMATION CONTAINED
ON THIS FORM IS COMPLETE AND ACCURATE.
~~~~, ~;;L.:-
Signature - '7 ~.5~
C:;,c./"y:/ C,~,r;:r b-/~--v7
PRINT DATE
(Please attach maD of insDection location)
FEES: $104.00 for Commercial Inspections; $ 57.50 for Residential Inspections
I
S:Permlts/Forms/Electricat Application Apr 2007
Driving Directions from 1 Civic Sq, Carmel, IN to 11599 N Keystone Ave, Carmel, IN
Page 1 oI2
Sorry! When printing directly from the browser your map may be incorrectly cropped. To print the
entire map, try clicking the "Printer-Friendly" link at the top of your results page.
_ 1 Civic Sq
Carmel, IN 46032-2584, US
Total Est. Time:
5 minutes
_ 11599 N Keystone Ave
Carmel, IN 46032, US
Total Est. Distance:
1.49 miles
Maneuvers
Distance
-
A
~
A
.
.<t
-
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 RIGHT onto S RANGE LINE RD.
0.6 miles
4: Turn LEFT onto E 116TH ST.
0.6 miles
5: End at 11599 N Keystone Ave
Carmel, IN 4603~,US
Total Est. Time: 5 minutes Total Est. Distance: 1.49 miles
http://www.mapquest.com/directions/main.adp?go= 1 &do=nw&rmm=l& 1 gi=O&un=m&I... 6/14/2007
Driving Directions from I Civic Sq, Carmel, IN to 11599 N Keystone Ave, Carmel, IN
Page 2 of2
Sorry! When printing directly from the browser your map may be incorrectly cropped. To print the
entire map, try clicking the "Printer-Friendly" iink at the top of your results page.
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Survey Boundaries
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Survey Boundaries
- Township Lines
Transportation
Abc Interstate Hwy Text
Abc U.S. HwyText
Abc State HwyT ext
:::ICII Interstate Highways
:::ICII U.S. Highways
- State Highways
:::ICII Primary Roads
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Friday, June 15, 200711:51 AM