HomeMy WebLinkAbout1435.96 Application&arnt l e lay Permit No_ /
Township Application for Date
Improvement Location Permit Roll File
This permit is valid only if construction is started within 120 days of issuance date; all construction is completed (c/o issued) within 2 years of
issuance date unless an extension of time has been officially granted by letter by the Director. Department of Community Development.
NAME PHONEQ 01, Vj J? PAX eOOC - ?
BUILDER S/L G?
9!% D
_S !G
STREET crry STATE ZIP
TENANT NAMT
(if applicable)
NAM PHONE FAX
OWNER
STREET//?j/J7 CItY //Jj STA:a ZfY
LOT SUBDR7SION SECTION
LOCATION G S T ?^
Csz E
AD1]RESS OF CONST0.l:CT7CN 7 - ?
v
A. TYPE Off' CONSTRUCTION F
1./ Single Family RECEIVED
2. ? Single Family Cluster
3. ? Two Family
4. ? Multi-Family DEC
5. ? Commercial / Industrial
6. ? Farm
7. ? OTHER (Specify)
IF so
B. TYPE OF SEWAGE DISPOSAL
d'17
S
1
EY"
f S
.
ystem (Name o
ystem
Nblic
2. ? Private (Septic Tank, etc.) G.
C. TYPE OF WATER H.
1. El`Public: System (Name of System I,
2. ? Private (Well _ l J.
D. ZONING CLASSIFICATIO OF PROPERTY K.
Present 11711
E. ESTIMATED COST OF CONSTRUCTION
(Excluding Land Value) y? D494 r '0 CJ
TYPE OF 131PROVEMENT
1. 01--RTew Structure
2. ? Commercial Tenant Space
3. ? Addition Porch Room
4. ? Remodel
5. ? Foundation Only
6. ? Demolition
7. ? Accessory Building
S. ? Swimming Pool
9. ? Garage Detached Attached
Lot Split
Flood Zones
Sump Pump
Marnufactured Trusses
Plumbing CODE
Plumbing Contractor
Plumbing License # _
YES NO
YES NO !}"
YES ? NO
NO) ?
S,0O?, or O:ABO
d
The undersigned agrees that any construction, reconstruction, enlargement, relocation, or alteration of structure, or any change in the use
of land or structures requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the
"Zoning Ordinance of Carmel Indiana - 1993" (Z-2$9) and amendments, adopted under authority of Acts of 1979, Public Law 178 Sec.
1 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto.
I further certify that the construction will not he used or occupied until a Certificate of Occupancy has been issued by the
Department of Community Development, Carmel, Indiana.
I furthej zPttify that only kitchens, bath, laundry, and floor OV are connected to the sanitary sewer.
of 9wner or Authorized Agent
City State Zip Phone
Sewer Capacity Allotted. 11,194t?
Cotnmuntiy
tin nder Slab ugh-In eder e
ons Needed
t,,,4] v Mage Sit in 00
"!,Plan (S-ge44tE.gC)
Cot7rzmis `on
CZA ocket 4 £hspc ti n Fees a - of Occupancy
by
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