HomeMy WebLinkAbout0189.97 Application �:ay Permif No. l� lff/
; ���,, AppGcation for DBC� /
' *'� Improvement Location Permit Roll File
,t is valid'�only if construction is stsrted within 120 days of issuence da[e;ell wnsWction must bc wmpleted(c/o issued)within 2 years of issuance,
.zss antMension of[ime has 6een otficiall ranted b letter b [he Director; —rtment of Communi Services.
�� NAME PNONF. � FAX
sUILDER /�f//�/��f Bt//LUE�'S �/7 3 S9 �/��� 311 / S$S
. _ �rrneer cm' � srnre z�a
- �3l£ N: i9 LlNy To✓ l NO/f�N9PDUf � 5��Z/ `Y
TENANT'NAME ��,�` G���,�
ifa liceble) '�—
'NAME PHONE FAX
OWNER
32 5 D q s�. � �,- . ��m �%eJ yP ylo 0 3 z
LOT SUBDMSION SECIION
LOCATION
ZL9 /�a �L-R 1=5T 7E5 �
MDRFS4 OF�CONSIAUCIION
;yy°ii rcpN�,�,t 4z.
A. TYPE OF CONSTRUCTION Do plans include a p h 7 F. TYPE'OF IMPROVEMENT
l. 0" Single Femily ❑Yes� 1. B'New Structure
2. ❑ Two Family 2. ❑ Addiaon Porch_Room_
3. ❑ Multi-Femily Type of � on: 3. ❑ Remodgl ❑ Commercial Tenant Space
4. ❑ Commercial/IndusU-ial ❑Cra ,� 4. ❑ Foundation Only
5. O Fartn asement �� 5. ❑ Demolilion
6. ❑ OTI-IER ❑Slab � ❑ Accessory Building
�SP��Y) ��2 Swunming Pool
B: SEWEI� � D, 8 � 8. ❑ Garage Detached Attached
1. C��Public (Name of System ��� � '9�G. Lot Split YES NO _
2. ❑ Private(Septic Tank,etc.) � H: Flood Zones YES _ NO _
C. WATEjt: � �J I. Sump Pump YES _ NO _
1. Q�Public (Name ofSystem .�'��J� ' � ManufaMured Trueaea YES _ NO _
2. ❑ Private(Well 9,fj '
D. ZONIlVG: � � �� umbing Contractor i{/o�ca i�.�...r��
E. E$TIMATED'COST OF CONSTRUGTI� � %�' J
(Excluding Land Value) �-�-d �� v� � `9i9j ing ticense#J�C l0 6 a 03 ❑BOCA or O CABO
. _ .
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The undersigned agrees that any construction,reconstruction,enlar en[,rel auon�or alt�arion of siructure,or eny ohange in the use of lend
or strucnues requested by this application will comply with,and conto 1 applicable law�o�o'tlt`e-Stale of Indiana,snd the"Zoning Ordinance
of Carmel Indiana- 1993"(Z-289)and acnendments,adopted'under�uuUionty of I C 36a7�r'et�Ge�q�er�al���diUiyja"�f t/he S�a[e of Indiana,and all
Acts�amendatorV[here[o. 1 fiuther certify ttia[only kitchen,bath,.laundry;end�floor di�a�c`sFar rconnu`t'ed�te th������ary��dtJ,�j fur[her.certify
t6at the:construction will,not,be u'sed or cu ied untd a Cerd'ftcate oJOccuponcy has'beeli'iiiss y tti4�D� attmenC of Community
Servicxs, Carmel,Indiana � � �� �'U��/j ����� O�� t'p,�
��n��2�'�'1 !`,' ns t9o�1'ge,�` e—��
/� �jGlQOn'Y���,: ' ` r ��f riylE�I?
�i�� �."��ch. - " wg/Uod'erslab� R.ough=ln Meter Bese
Signature of Ownerbr Authonzed pgeut 3 � �.'�QEf
������������ Site Final C/O j�
�'.���Gd 7 '
(Print) (Phone Number) /�h��,�-��Pemut(Sq � C/
v �j �� �p
Sewer Capaciry Allotted-��� �/l.(i(; Idspection Fees: �-iza��2CL
Plan Commission/BZADocket# ' � Ce i cate of Ocoupan �D
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TOT .
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w Appoved'-Dep[.,pf.CommuniTyServices � FeeReceivedBy .:�.�emm��
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