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05030128-Application
BUILDER: OWNER: Pool / Spa o, Construction Fax P.O. Box / Address City State Name Phone Fax ) Street Address City State Lot No. Sub 6n Location: Address of Construction Estimated Cost of Construction: (Pool and Deck) Pool Heated: Y/N Flood Zone: Y/N City State Zip Zip Zip TOTAL SQ, FOOTAGE: (Pool and Deck) ~---~-'Q-~_ Pool Cover: Y~ ~ Septic System:Y/N Auto Filter: ~LEAS ~ C© NSTR UC?~ ~nU~icPlteYdr/r/~mna e on~ ~ub~ect to com~Ii~ i~.ce with all ragut~i(g~ g of State ant Local Codes, For Commermal Pools, state Class o~ ~t: Commercial Pools - provide S D E T OF COMMUNt'~ SERVICES by this application, will comply with a 11 applicable laws of thc State of Indiana (for residential pools, 675 iAC 20-1,1-1 through 20-1,1-22 and 675 lAC 104-1 thi'ough 20-4-271 for commercial pools, 675 lAC 20-1.1-1 through 20-3-9) 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 Acls amenflatory thereto. Safety features (including pool covers) shall comply with Indiana Swimming Pool ~odes 675 IAC 10-4-27 "Safety Features'. i hereby certify that the improvement / swannung pool will not be used or occupied until a Certificate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana. (Print) r----1 iPhone No.) BZA Approval: Y/N b.___J ~~PECTIONS RE UIRED..(~ FEES: Pem~it l~ee: [nspecuon Fees: Cert. Of Occupancy: -FOTAL: