HomeMy WebLinkAbout0205.97 Application Carmel-Clay Permit No. Q��iif`
� Application for � Da�
t° =' ImprovementLocationPermit R°vF''e
This�permrt is,vAlid�only;if construcAon is`stsited within 120�days of issuance date;all wnsVUCtionmust be completed(c/o issued)witt�in�2 years of issuance;
�dat8;unless�aniextens�onof[imehnsbeenofficiall rantbd�.6 ,letterb theDirector,De en[ofCommunit �Services.
NAME PHONE 'FA%
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TENANTNAME
(if a� licable ,
NAME PHONE FAX �
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STREEf . . . . CI'IY. STATE TJP
LM SUBUMSION SECf10N
LOCATION W�S�n !�/'^ '�,
pDDRESS"OFCONSfitUC110H .
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A. TYPE OF CONSTRUCTION Do plans inclu8e a porch 7 F. TYPE OF IlYIPROVEMENT
1. �: Single Femily �Yes❑-No 1. � New Structure
2. ❑ Two Femily 2. ❑ Addihon Porch_Room_
3. ❑ Mulh-Family Type of Foimda' 3. ❑ Remodel ❑ Commercial Tenant Space
4. ❑ Commercial/Indusuial Crawlspace � A. ❑ Foundation Only
$. ❑ Fa�m �asemerit 5. Q Demolition
6 ❑ OTHER ❑Slab f -. ���-❑ AccessoryBuilding
�SP��Y) � Swimming Pool
B. SEWER: � �6+ 8. azage ,Detac&ed Atiached
1. �[ PubLc (Nazne of Systein cT,� wv , ���pLot Sp YES NO
2. ❑ Privatei(Septic Tank,etcJ' H. Flood Zonea PES NO �
C. WATER: I. Sump Pump YES � NO
1. � Pu6lic (Name of System p J. ManufaMUred Trusaes YES NO _
2 ❑ Private(Well
D. ZONING: � -� � bing;Contraetor �-�� ���✓�
E. ESTIMATED COST OF CONSTR CTI �
xcludm LandValue MA � C P�j'/��,5zO5
(E , g ) � � j997 P mbing Ircense#' ❑BOCA or IY�CABO
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The undersigned agraes that eny cunstruclion,reconstructio ,, ement,rel ation,or alteration'of suvcture,or any change in the use of land
or s�uctiues requestedby this application will comply�+�lh,and conform't , pphcable•laws of the State'of Indiana,aod tbe"Zooing Ordineuce
of Carmel��Indiana�-'1993°{Z-289).:and amendments,�adopted� . - , � � I C� 36�-7 et seq�GeneFal Assembly'of the State of Indiana,"end ell
t ^i�- y Ls�«c .�
Acts amendatory;ihereto I fiuYher certify that only kit ,bath,laundry,end fl drauv,taze coimected�to the�sazvtary.sewer. I fuKher certlfy
vi�l`9�`=P�`J ITR'.1}4r,.
tbaY t6e construct�on will`nol be%used or occup' until a fuate ap "�-:fi�b� ued by-t6e�Deprar,tment of Commuuity-
Services, Carmel,Indiana ��/I�� 11 °�;.�,�.�$�. ����d� C3P� ��Q��PC3jp�
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�gn rAuthorved�Agent ,-_,y t� _p 0 ` wYPT) " .
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(Print) hone Numbei) ` � '�
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Sewer Capacity Allotted (,.O " � Inspection Fees:
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Plan Comnussio A ocket#: Certificate of Occu y:
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pproved: ept:of Coiqiriuruty:Sernces FceReceived By .:v�,��. m i�