HomeMy WebLinkAbout04110049-ApplicationTownship Application for \l
Hold #: Improvement Location Permtt
Irifis permi't is valid only if conslxuction is ~tarted within 180 days of the date of issuance for residential construction; and for commercial projects, within one (1)
NAME ZONE FAX
BUILDER
OVOIER
PHONE
STREET CITY
LOT SUBDIVISION
LOCATION ~ '~ x,,~,
ADDRESS OF CONSTRUCTION
A. TYPE OF CONSTRUCTION Do plans ineludea porch,* F. TYPE OF~IMPROVEMENT
1. [~l~mgle Family ~t~res [] No /~-~,~ 1. ~'"~New Structure
2. [] TwoFamily /fo }2. [] Addition: Porch _ Room
3, [] Multi-Family Type of FoT~o~Ol~,~~ //3. [] Remodel FI Commercial Temmt Space
4. [] Commerc/al/Industrial [] Crawlsl~ce ~_~,~ 4. [] FotmdationOnly
5. FI OTHER I]~Base 5: [] Demolition
(Specify) [] Slab 6. [] AccessoryBuilding
-- - ~ ~.l~'~ ' 7. ~ Garage Detached Attached .~
B. SEWER:
1. ~ublic (Name ofsyste~~
2. [] Private (County pen'nit # ' _ ) G. Lot Split YES NO
C. WATER: H. Flood Zones YES NO
1. [l~'Itrdblic YES ~'~-- NO
2. [] YES NO--
I, the undersigned, agree that any construction, reconstruction, my change in the use oftand or structure,s,
requested by this application will comply with and conform to, all applicable laws of the State of Indian~ and the "Zoning Ordinance of Carmel Indiana - 199Y
(Z2289) an~ amand~nents adopted u~der authority of I.C. 36-7 et s~q, General Assembly of the State o£Indiana, and all Acts amandatory thereto. I further
certify that only kitohen, bath, and floor drains are connected to the sanitary sewer. I fnrther certify that the construction will not be used or occupied until a
by the Department of Community Services, Carmel, Indiana.
~Signamre of Owner or A~thorized Agent
(Phone Number)
E-Marl: .rC~~
Revilwe ;d/ ~Approved: Dept. of Community Services
Filing Fees: ..~0
Base Inspections: ~
Cert, of Occupancy: ~ //
Fee Received by S:Permits/Forms/ILPS-02