HomeMy WebLinkAbout0006.99 ApplicationClay �. �� PP pejoy � 6Aq
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This permit is valid only if construction is started within 120 days of issuance date; all construction must b
date unless an extension of time has been officially Aranted�by Iettef by -the Director, Deuartment of Comn
(c/o issued) within 2 years of issuance,.
NAME
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PHONE
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FAX
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BUILDER
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SWEET
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STATE
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TENANT.NAME
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(if applicable)
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OWNER
NAME
PHONE
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'FAX
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CITY
SPATE
ZJP
LOT
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LOCATION
ADORE Cf
'OF CONSIRUCnONAdo
2 yd
A. TYPE OF. CONSTRUCTION. Do plans include a porch.? O . IMPROVE
ir,
1. ❑ Single Family ❑ Yes�o w°'5`tiilclure ,
2. ❑ Two'Family 2. Addition P rch —Room
3. ❑Multi -Family Type of Foundation: 3. ❑ Remodel Commercial Tenani�Space
4. Commercial / Industrial ❑Crawls ace + U,
5. ❑ Farm mo i
SO
6. ❑ OTHER a )tegrrlmrion,;
(Specify) of Srajit ca1 Ghfc i
B. SEWER:, DEC 3m%� Ached
1 K'Pubhc (Name of System G. .f NO ✓
2, Private (Septic Tank, etc.) s' Z.. YES NO �—
C. WATER: 7 ee� YES NO
1. , Public (Name o stem anu a red 1,r ruZeS YES NO
2. Private(Well' i
D. ZONING: K: Plumbing.Contractor Zr;Tt �C__TT(r _
E. ESTIMATED COST Of CONS RUCTION /�
(Excluding,Land,Value) C� (%G- License#'19 Doo20 OCAor❑CABO
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The'undefsigned agrees that any construbtion,.reconstructi n, enl-# npnt r on; orl alteration of structure, or any change in the use of land
or structures requested by t}iis application,will comply wi and co—nfo m to aI icable laws of the State of Indiana, and the "Zoning Ordinance'
of Carmel Induma - 1993" (Z-289) and amendments, adopt authority of I.C. 36-7 let seq, General Assembly'of the,Stafe of Indiana, and all
Acts amendatory thereto. I further certify that only kitch 3looe$Eaid, are connected to, the: sanitary sewer. I furthercertify
that- the constructionwil not be used or occupied7BY
:o cy'has been issued by the Department of Community
Services, Carmel, Indiana.Inspections N el
Foot' g/IJnderslab ough= Meter Base
Signaturee of IOwner�o%i-,Au torized'A/gent G `
(fAr �?Jr V_ P Q//c(OS D �2 - z �1 ? Site inal
(Print) hone Number) Permit"(Square Footage)
Sewer Capacity Allotted Inspection Fees:�U
Plan Commission/BZA Docket #: Certificate of Occupanc
TOTAL:
CC
evle p rov :Dept. of Community Services �� Fee Received By .: wPsssm m Izva