HomeMy WebLinkAbout07060233 Application
City of Carmel! Clay Township
APPLICATION FOR ELECTRICAL INSPECTION
CJ ~06 ()r2"3 3
NAME
PHONE
FAX
CONTRACTOR
INFORMATION: Street Address
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NAME
City
State
Zip
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CONTACf PHONE:
APPLICANT
INFORMATION:
OR
Contractor
Representative
TYPE of WORK:
RESIDENTIAL:
COMMERCIAL:
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PROPERTY OWNER NAME(S):
PHONE:
PROPERTY
OWNER
INFORMATION:
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STREET ADDRESS:
City
State
Zip!
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City State
Zip
STREET ADDRESS (INSPECTlON LOCATION):
INSPECTION
INFORMATION:
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TIME OF INSPECTION:
DATE OF INSPECTION:
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TYPE OF IMPROVEMENT:
/V
,
MOVING SERVICE FROM OVERHEAD'
TO UNDERGROUND? I
I
I
DYES
o NO
o UPGRADE SERVICE: From to
o UPGRADE PANEL BOARD(S)
Number of NEW CIRCUITS:
o ADDmON, ALTERATION, REMODEL, or REPAIR TO
AN EXISTING ELECTRICAL DISTRIBUION SYSTEM
Number of METERS:
I
o NEW METER SERVICE (i.e. 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 AN CCURATE.
o ROW SIGNAL, SENSOR, MONITOR (i.e. Traffic Light)
Signature
o CONNECTION or RECONNECTION TO A RELOCATED
STRUCTURE
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PRINT
61th
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r FURTHER LOCATION CLARIFICATION: (Please attach maD of insDection location)
_ O..,DO for Commercial Inspection-5i-$..S5.S0 for Residential Inspections
S:PermltsjFormsjElectflcal AppHcatlon Apr 2006
Driving Directions from 1 Civic Sq, Carmel, IN to 14599 Jason St, Carmel, IN
Page I of2
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entire map, try clicking the "Printer-Friendly" link at the top of your results page.
"'R77'
lID 1 Civic Sq
Carmel, IN 46032-2584, US
III 14599 Jason St
Carmel, IN 46033-8759, US
Total Est. Time:
9 minutes
Total Est. Distance:
3.79 miles
Maneuvers
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Distance
1: Start out goin9 EAST on CIVIC SQ toward GRADLE DR.
2: Turn LEFT onto GRADLE DR.
<0.1 miles
<0.1 miles
3: Turn LEFT onto S RANGE LINE RD.
0.3 miles
4: Turn RIGHT onto E 126TH ST.
0.7 miies
5: Turn LEFT onto N KEYSTONE AVE 1 IN-431 N. Continue to foilow IN-431
N.
6: Take the 146TH ST ramp.
7: Turn RIGHT onto E 146TH ST.
1.5 miles
0.6 miles
0.3 miles
<0.1 miles
8: Turn ~ onto JASON ST.
Prtft-i'
9: End at 14599 Jason St
Carmel, IN46033:87~9,U?
Total Est. Time: 9 minutes Total Est. Distance: 3.79 miles
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httplllwww.mapquest.com/directions/main.adp?go= I &do=nw&rmm= I & 1 gi=O&un=m&I... 6/26/2007
Driving Directions from 1 Civic Sq, Carmel, IN to 14599 Jason St, Carmel, IN
Page 2 of2
Sorry! When printing directly from the browser your map may be incorrectly cropped, To print the
entire map, try clicking the "Printer.Friendly" link at the top of your results page.
All rigbJs-L€se.QLed--,----lJ$e Subj~clli Ucen~~/CQR.yJjgbt
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= 1 &do=nw &nnm= 1 & 1 gi=O&un=m& 1... 6/26/2007