HomeMy WebLinkAbout0203.97 Application Carmel-Clay Petmit No.- ��
T��� Application for � Date 3/ �
Improvement Location Permit R°u F''
This pertnit is�valid only if consWction issfarted;within 120 days of issuance date;all wnsWction must be compleled(c/o issued)witltin 2 yeers of issuance,
date unless an extension of dme hes been officinlf ran[ed b letter b the Direc[or,De rtment of Communitv Servicea �
NAME /�,, � ��� � �P�HONE ,p `p� ry FAX,�y�
BUII.DER /l.�'w� .�:C!/.ua/ �/I G ✓M 'cY�G� 4J7.�a3��o7
�`37.SS �'� �0l/10� � �i . /070 �o/ . �a �p 5��015�0
TGNAMCNAME
ifa licable '
� rvneee L� v�vc
OWNER
SIAEEI' CffY SfAIE T�P
LOT LIBDMSION SECIION
� LOCATION �6 �J lO '
ADDRFSS OF�CONSIIIUCIION �
96� �����/ L�
A. TYPE OF'CONSTRUCTION Do plaos incl e,�p�ch? F. TYPE� gF II1iPROVEMENT
I. C�Single Family ❑Yes_A�� 1• CA' New Struchue
2. ❑ Two Femily � 2 ❑ Addidon Porch_Room_
3. ❑ Mula=Femily Type of Fou�on: � 3.: ❑ Remodel ❑ Commercial Tenant Space
4: ❑ Commercial/IndusVial OG aw : � 4,% ❑ Fowdation Ocily
5! ❑ Fazm � `� 5. '❑ Demolition
6. ❑ OTHER ❑Sla�' � 0 �6. ❑ AccessoryBuilding
(SPecify) ���'p� �7. ❑ Swimming Pool
B. SEWE�: ��,�N '•�f :`� -� S. ❑ Garage Detached Attached
l. f�� PubGc (Neme of System- G. LotBpGt YES _ NO I�
2. ❑ Private(Septio Tank,etcJ H. Flood Zones YES NO �
�: WATER: I. Sump Pump YES NO _
l. '�Public'(Name of System �NQPLS ) J. Manufactured Ttussea YES _ NO _
2. ❑ Private(We P
D. ZONING: � K.. Plumbing Contractor � T��-Dn7.Ci
E. ESTIMATED COST OF CO STRUCT ON � p
(Excluding Lend Value) �Id 7S Plumbing License#����a�A�`�BOCA or❑CABO
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The undersigned agrees that any constnibtien,ieconswotion,enlargemen[;reli�cation,or:alteration of swchue,or any change in the use of land
or strtictims requested by this applicatibn will comply witl�,and conform to,ell applicabl�rws of ihe State of Indiana,and the"Zoning Ordinance
of Cermellndiana- 1993"�(Z-289).eud aznendments,adopted under authority of I C`36-7r��qt�C n��s�e,mbly'of the State of Indiana,and�nll
Acts amendatory thereto. I fu�Yher certify that only kitchen,bath,laundry,and�floor dra�cu are�connec�ied to ih��nftazy�sewer. I further certify
iv�, �er.ine, v' !!
_ that thernnatruction will not be uaed'.or occupied uuf�l a CertiJicate ojOccupnncy hab�beyn usuedt6yqjhe Depa nt Community
Servicee, Carmel,Indiana �-. . � �[n V.£�}B�,Q �r��l�� v��
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irLy,GG R O '�if.�
/�� � � '/ nu�d ��
iCd=.CJ�/d�i ,f'. � 'ting/Uudersl�ab Yir�h='�M�"f�i�8�'se
Signahtre of Owner or Aatliorized Agent. �g ,� `y � ..r17 y �
Or �-l. !'///,7�i .�9� ..�`�.. fa'��.1�`�� s�te Fival ..�aQ .. � :J
� �
(Prin[) (P one�N ber)� �99j Permt�(Squaze Foo[age) � -'�
-�-� � � ��r�
Sewer Capacity Allotted� � Iiu�tion Pces: �
Plan CommissionB ocket#: \ Certificate of Occ ency ��
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TOT :
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ewed/ PProved: Dept.of Community Services Fee Recei� By .:�+�a�+ m��
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