HomeMy WebLinkAbout05020107-ApplicationOWNER:
& PROJECT
INFO:
WATER UTILITY
PROVIDER:
or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
~r Institutional: New Structures, Additions, Remodels, Tenant finishes, &Accessory Buildings
:ONSTEUCTJON
(If different man Addres~ of Construc~on)
~ FAX ~
STATE
SUITE# (If Applicable)
# an~ SulXllviSlon (If Applicable)
ZONING: TAX HAP PARCEL #:
ELEC
ROViDER: t
COUNTY WELL AND/OR SEPTIC PERMIT #~ (If A~pllcable):
[] NEW STRUCTURE
[] ADD1TJON
PRO - ; ,_- AFl -:
Early .Re. lease \ - Manufactured
Permit, y ~ Trusses: _
Lot Split: Y ~
part of the property lie within a special Hood
designation area: Y_
[ [~.I/~' ATTACHED 6ARAGE ~-- --
[] CRAWLSPACE C:] CELLTOWER(New) Plumber'slndianaStateUcense#~
BASEMENT [] CELL TOWER CO~LOCI. TE
(orPOST & PIER) WALKOUT: Y N C21 DE~IOL1TION
I structure pex~mits are su~ec ~ 675 I~C 12) z
[, the undersigned. ~gree that any construction, reconstruction, ~ ny change in the use o['land or srructu[e~.
z~quested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the 'Zoning Ordinance of Carmd In~ - 1993 (Z-
289) and an~ckl~e~t a, adopted under authority of I,C. 36-7 et seq, General Assembly of the State of Indi.ana, a~.,d all Acts aranndatozy t~. ereto..I, further.c, ertffy t?t only
kltchea3ebff~]h, ~oor ~ a~ connected to the sanitazy sewer. I further certify thax the cov~strucuon will no~?a~used or occupxed until a Cert:ffi'cate o£
Occ~R~o} &~t~.g~Canh~letfon~h.a~ been issued by the Depsst~gn~of Community Services, Carmd, In
Signa~ure'"of (~wner or~uthorlzed Agent Print ( Date
Filing Fees:
Under Slab Base Inspections: / Reviews
Cert, I/
Additional Fees
(Da~)