HomeMy WebLinkAbout0003.94 Applicationarme lay Improvement Location Permit Permit
Towns ip Date 3
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) two
years of issuance date unless an extension of time has been officially granted by letter by the Director, Department of Community
Development.
NAME
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PHONE
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BUILDER
STREET `
CITY
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SATE ZIP
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TENANT NAME
(if applicable)
NAME r/%��
PHONE
OWNER
STREET
CITY
STATE ZIP
DEC;
LOT SUBDIVISION /
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SECTION I
LOCATION d�•'CE.L)
"
ADDRESS OFCONSTRUC Nj
A. TYPE OF CONSTRUCTION
1. �R Residential (One or Two Family)
2.0 Residential (Multi -family)
3.0 Commercial
4.0 Industrial
5.0 Institutional
B. TYPE OF SEWAGE DISPOSAL CT/L�✓O
1. e Public (Name of System )
2.0 Private (Septic Tank, etc.)
C. TYPE OF WATER
Lp Public System (Name of System ,fiqVig,�.g Li f )
2.0 Private (Well )
D. TYPE OF IMPROVEMENT
LR New Stucture
2.0 Commercial Tenant Space
3.0 Addition Porch Room
4.0 Remodel
5.0 Foundation Only
6.0 Demolition
7.0 Accessory Building
8.0 Swimming Pool
9.0 Garage Detached Attached
E. ZONING CLASSIFICATION OF PROPERTY
n,.o +
F. PRESENT USE OF PROPERTY
U-01 Farm/Vacant
2.0 Residential (One or Two Family)
3.0 Commercial
4.0 Industrial
5.0 Other (Specify)
G. PROPOSED USE OF PROPERTY
1. (Z One or Two Family Dwelling
2.0 Multi -family
3.0 Commercial/Industrial
4.0 Other (Specify)
H. ESTIMATE COST OF CONSTRUCTION_
/ZO all U
(Excluding Land Value)
k
I. Lot Split: Yes
No
J. Flood Zones: Yes
No - e
K. Sump Pump: Yes
No X
L. Geothermal Heat Pump: Yes_,_
No J(
M. Manufactured Trusses: Yes %<
No
N. Plumbing Contractor R.—,r le^d CODE: BOCA or CABO
Plumbing License Number: 9z V aor20!'•
The undersigned agrees that any construction, reconstruction, enlargement, relocation or alteration of structure, or any change in the use
of land or stuctures requested by this application will comply with, and comform to, all applicable laws of the State of Indiana, and the
"Zoning Ordinance of Carmel, Indiana—1980", adopted under the 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 be used or occupied until a certificate of occupancy has been issued by the Department of
Community Development, Carmel, Indiana.
I further certify that only kitchen, bath, laundry and floor drains are
connected to sanitary sewer.
ignature of Owner or Aut orized gent
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Inspections 4 ottn
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t, Square Footage
P'nl (Sq. Footage) .....................
rlt wins ons......................................
,VCertito of Occupancy ..............
T.......................................... .
omm./BZA Docket # , J
I CERTIFY THAT ALL OF THE ABOVE LISTED INFORMATION IS SHOWN COMPLETELY AND ACCURATELY ON THE
ATTACHED PLOT OR SITE PLAN AS SUBMITTED WITH A BUILDING PERMIT APPLICATION TO THE CARMEL-CLAY
DEPARTMENT OF COMMUNITY DEVELOPMENT. I FURTHER CERTIFY THAT THE JOINING OF WATER SUPPLY
PIPING SHALL BE MADE WITH LEAD-FREE SOLDERS AND FLUXES. FAILURE TO COMPLY WILL RESULT IN A
REPLACEMENT OF THE SYSTEM. PLUMBING CODE P-509-5.
BUILDER'S SIGNATURE:
ADDRESS: 1041 West Main Street
PHONE: 582-2447
NOTE: Additional plans and/or information may be required, if submitted plans are not of sufficient clarity or detail, to
indicate the nature and extent of the work proposed and to determine compliance with all applicable codes and
ordinances.
In addition to the above, the Building Inspector will be provided with any information relative to commitments made
in the zoning process for the property involved. This would include any ADLS and BZA activity.
July, 1993 C:\TEXT\1006 dep