HomeMy WebLinkAbout0192.97 Application Carmel-Clay Permit No. �y 1
;�s�n;� Application:for � nec�� �/:���
�--' Improvement.Location Per�nit Roll File
Thispermif is�velid orily if wnstiuction.is sferfed�within 120.tleys of issuance dete;all construction must be completcd�(c/o issued)within 2 yesrs of issuance;.
.date�.unless an extrnsion of time has been ofticiell rented b�letter 6�the Director,De ertment of Communi Services.
Nnn1e- � rxone aac _
BUII.DER. P,M �,}�,� �,`5� $II�- o5Z'� �SZ -��57
SIREEI' CT' SfA'IE T!P
q 7'�7� So.or,u��ic5 ��, ��t,rne� 1. 603 Z
TENANf NAME
�if-'a IiceBle
NAME PNONE FA% '
owivEx �1 C�;�t n `JI(�_ 05 Z.� �K62 - (�(���
SIItEEI' CI'IY SfAIE TJP
�� s�,„ Y� D� � o
��ar suecrv(s�oN '/ secnoN
LOCATION y� 5✓^�cr�K?5 Z
ADDRPS4�OF CONSfRUCf10N '
1 (0�' m !1 C. FrM � � Z
A. 17'PE OF CONSTRUCTION Do plans include a po F. TYPE F IMPROVEMENT
l. Lg Single Fsmily �Yes�No 1. �New Swcture
2 ❑ Two Family �� 2. ❑ Addition Porch_Room_
3. ❑ Mu1ti-Family Type of Foundation: ❑ Remalei ❑ Commercial Tenant Space
4. � Commercial/Industriel OCrawlspace-�% �� ❑ Foundalion Only
5. ❑ Fazm QBasement "�� Demolition
6. ❑ O'I'f�R ❑Slab V7, 6: ssory;Building
(SPecily) •[�y5m�. g Pool
B. SEWER: ' n 8. ❑ Gazage Detached Attached�
i. L� Public �t_�v
(Name of System' "� G. Lof Split YES _ NO _
2. ❑ Private(Septic Tenk,etc.) H. Flood Zones YES _ NO '!
C. WATER: y��,,,,�y�.,� I. Sump Pump YES ✓ NO _
1. C� Public (Name of System__'" /� J. Manufactured Tri�sae9 YES _ NO ✓
2. ❑ Private(Well' ) J I
D. ZOMNG: �-� K: PlumbingGontractur ,�hu�� Qlu�, 6i�ci
E. EST[MATED COST OF CONS�UCTION
(Excluding Land Velue), 2��� Plumbing'Licenae#1 Q30o y L+�BOCA or❑CABO
rrssssssasir►sts�►�4�at..sw+ss�.■s*..s.�rs++wrtsrrs■�a�*a�rrsxr►t�af�si*sssa"sxr++f++�rsrss�r�tr�.s►rssssaasar ��
The undersigned agrees ihat any construction,reconsauction,enlargement,relocation,or alteration"of structure,or any change in the use of land
�structures requested by this applicarion will comply wiih,and conform to,all applicable laws of the State of Indiana;and the"Zoning Ordinance
of Cacutel Indiene- 1993"(�289)and�amendments,adopted mdei authority of[:C.�36-7 et seq,General"Asseii�bly'of[he State of Indiena,end all
Acts amendatory t}�eieto. I further certify that only kitch eth,laundry;and floor drauu.aze connec[ed lo,the senitary sewer. I further certity
t6at'the.conatruction wlll not�be uaed.or occupied. -erd'ftcate ojOccupancy:has.been��isaued�by��the��Depar[ment��of Community
Servicea, Cai�mel,Indinna� �
� � .Inspections Needed:
�// % 'y�
i/���¢.i�l.f�/i/C�!�� �� 9��11 ojtti� �~ �dersl� Rough- eterBase � .
Signature o O or:Au[horized Agent �,$�9� , '
\ �aj ;�'�Sate '�'al 6!O
B•' �."..;,'` f.
G .�r. c-,�+;wp�, `y
(Printj (PhoneNomber) oe ,`^h�" age) �4� �00 -].�4�
Sewer Capacity Allotted �'�2Qr, a.l 19Q1 �� t'� v , � a.50.00
ff'" G�'�a�a�����.
Plan CommissionBZ,A Docket#:����ti'���o�G��i� EOccupency: .
� y-
5 Q�Q O�GP' 01� / 10;;00
�I't`h � .. �� Y j� " l � �
Reviewed/A proved: Dep[.of Communiry Services G Received By .:�.��. m��