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HomeMy WebLinkAbout0204.97 Application Carmel-Cla}� �Permit N� _// � Toin+ Application for �- Dac�; ���/� Improvemerit Location Pe��nit R°u F�e Tfiis�.pertnit.is valid`only ifcons[ruction is�started within 120;days of issuance�date;all wnsWction�must be completed(c/o issued)within2 yeers ofissuance,� date unless an ez[ension of time��has-�.been ofTiciall' -ranted 6 letter bV.t6e��Director,De arhnent of Communi Services. �NAMF. PHONE FqX BUILDER' /� � � ' ,SIREEI' CITY SI'ATE� TJP C,a . �'� I �v �U�3 Z� 'IENANT NAME . (ifa licab!e)� � � -NAME �� . ?PHONE. � FAX' ,: OWN�R SIA2ET � °CITY' .. SfATE ZJP LOT �SIIpDMS10K � � SECIION LOCATION �l�� - 'I.�i� � .� ' ApDRESS OF�C�NSIRUCf10N / � Z '�f x9 7a�� -�7�n,Q; v A. TYPE'OF CONSTRUCTION Do plans include a oic6 ? F. TYPE OF II1iiPROVEMENT 1. � Single Fsrruly ❑Y�s o 1. fS New Structure 2. ❑ 1'wo Femily 2: ❑ Addiqon Poroh_Room_ 3. ❑ Mu?h-Femily Type of}oi h��: 3. ❑ Remodel ❑ Commercial Tenant Space 4. ❑ Commercial/Indusvial CGr 1 ce 4. ❑ FoundauomOnly 5. ❑ Farm ase� 5. ,❑ Demolivon 6. ❑ OTHER ❑Slab ��� 6. ❑ Accessory Building {Specify) �� ❑ Swimming Pool B. SEWER:� r /'�j� Garage Detached Attached 1. �' Public (Naine of Systew il. M I_U °�Y/j' � G. tit YES _ NO x 2. ❑ Private(SepticTank,eteJ '�l� Flood Zoues YES _ NO � C. WATER: � " � ' L Sump Pump. YES _� NO _ L � Public (Name of System��� J. ManufaMured Trusaes YES _ NO X 2. ❑ PrivsYe(We1P _ D. ZONING: -�I, K. PlumtiingC�ntractor �r✓�(LOr�c;, ( P. �TIMAg ED COST OF CONST i UCTION:oQ xcludin Land Value q Q? tXiYJ Plumbing License,#; .��UU�F�P �`BOCA or❑CABO +ts�as+ies*xrtt*a`�tsiit�rrt*as*"ss►#*�*ia**'tw"sfa*#+�*ss**e+t*s+to+es�ES�*s*weysssssxsi+!kaser+rMSSfrwswsYSSas*�s*s Tl�e undersigned agrees that,any construcfion,reconstruction;enlargement;relocation,or.alteration of striichue;or any change in tkie use of land ..,, _ or structures recjuested by diis appiicadon.will compty ev�th,and conform to,all applicable laws o1!he S[ate of Indiana,and the"Zoning Ordinance ofCaimel�Iudiana- 1993"(7-289)andainendmi,°nts;�adopteduaderauttiority�ofI.C. 36-7 et��.seq,;GeneralAssembly�oftheStateofIndiana�,_and�all Acts'ainendatory[hereto. I furthcr cenify;that only kitchen,bath,laundry,:and floor drain>-are connec[ed to-the sanitary sewer. I furt6er certify tLatYhe constn�ciion will'not bepsed or-ceeup' - il'a+Gerbficpfe ojOccupancy.has�been.issued by the Department of Community Services, Caitiiel;Indiana � � � n _ � Iuspections Needed: � � �'1AR 13 19 ra, -����� �- 9� out�n . nderslab��- Rough- eter Base Signature oE Owaer or A orized Agent � ,, � � �J I �/� �'l /!} .(tiSrte1. Final�: GO �,r7/7/JLI� iVU�ITs/Cr �:/�-UStv�l� � ,,�4 �` .�„�'r��. (Print) (Phone.Nutnbzr) ,�"�jti{S�c�nare,F�t��j �8�.00 41 SewerCapacityAllot[ed. �cwr.e�n \O��j1 `+`Ca�Inspectio„��'".l� �,,,�, J,�` �`a J �t �� q(�� �, Plan Commission/BZA Docket#: ��'�� C�ertifi"c,�t�o(�upancy: - — — �� �� ��� 0`P -n1J \ \� ��� �`�,��;• �6Q':V� 0 V�w�n ��161�5�`�A� ��� �� � � �� � �l �/ � ` Reviewed/Ap ._oved: Dept.of Commuaity Services G�'� eceived B j .:���a� !��� . `J`