HomeMy WebLinkAbout0193.97 Application a.�r'lgy Permit No ��
EL•pplieation for Date 3 0 � �
,
�� � Improveritent Location Per�nit �R°"F� �'
.pertnrt is:yalid only.if constructiom.is started,within 120:days of issuance date;all consWction must.bemmpleted(c/o.issued)within�2�years of issuance,
:[eunlessam"e#ensionoftime�has::beenofficiall�. �ranted6 .letter:6-.ttie�Di�ector,- -ertmentofCommuni �Services.
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TENANT NAME
.�(ife- �licAble
NAME PHONE FAX
o�R S:/� M E
. .. . STREEI' � .. . CffY STATE 9P
LOT SIIBDIVISION� SECI]ON
LOCATION I II R Q,f �LS�D'i'I �
ADOR2S5 OF.:CONSIRUCIIO
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A. 1`YPE OF'CONSTRUCTION; Do plans include a;porch 9 F. TYPE AF Il1�IPROVEMENT
1. ❑ Singla Feinily �(Yes O No 1. �I New Structure
2. � Two Family 2: ❑ Addition Porch_Room_
3. ❑ Mu1ti=Family Type of Foundation: 3. O Remodel ❑ Commercial Tenant Space
4'. ❑ Commercial/Industrial OGtawlspuce 4: ❑ Foundation Only
5. ❑ Fazm� O � ea:ent 5 ❑ Demolition
6. ❑ OTI�R 6 ❑ .AccassoryBuilding
{Speoify) � 7. ❑ Swimming Pool
B. SEWER: �� 8. ❑ Garage Detached Attached
l. 'f(] Pu6lic (Nazne of SystemG. �/ W�/�� 'j� t SpGt YES N�
2. ❑ Private(Septic Taolc,etc:) "'T/r lood Zones YES NO �
G. WATER: 9� I. Sump Pump. YES _ NO !X
1. � Public,(Name ofSystem ND PL� J. Manufactured Trusaea YES � NO
2. ❑ Private(Well'
A .ZONIlVG: s— � �,99 Plumbing'Contractor � T �ODYCi
E. `ESTIMATED COST OF'CON$TRUCTIO, �� n
(Excludmg Land Value) ��` �� ' 1J l'�O` ing��eu0�/s�05 p BOCA w f�CABO
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The undersigned"agrees ihat,any.coaswction,reoon`swction,e emen[;rel tion,il9�ytetation of structwe;or any change in the use of lend
or.shvcw�+es requesled by this application w�ll comply wi to,: applibatile laws��f the State of Indiana,+and[he"Zoning Ordinance
of Ceimel Indiana- 1993"�+(�289)and:�amendments, opted under autho f I C 36;;7 e°CSeq,�Geuetrall'Assemtily of the�State of Indiana,and all
Acts�amendatory�thereto. :I�fwther�certifytha4o �ki[chen,.ba[h,�laundry;an oordrairuareconn'ECt�to~tltre-satutary�.sewer. I fS�rt6ercertify
� rP�+ P!SI_ 1 �N{'1
t6afthe couatruction!will�not.be used'or cu �ed until a�Cer[i uate o "ancy has�been�ssued,�bythe�Departmeut of.Commuoity
�U �°aQ ° � �TU(�'�j�
Servicea, Carmel,Indiaoa P r f ��f/A• .�'' � �
���U��u�, �l /� n eeded:�� �f ��!�
^ � (} �r�� q- Y V /'��(�`,�yV_�`�"'C�d/ �c�"��QO'
` (��4' �- t'�D ��dd'erslab �N{pygh-�i'.<Q, �et��Bas.e dog�
Si�ature of Owner or Auth�rized Agent � �j p S�r `�� �^!j
- ��Site'- Fin r�.� - //�
� GV�;�'�(1 �ZOV�L�-:Vd 5oZ-Z¢�I� -Q/�d0 �l�L[ �
(Print) - (Ph e Numtier) �Permit(Square Footage) �() / ���6�/
Sewer Gapacity Allotted C� Inspgction Fees: ��
Plan Comcaissio DockeY#: (s'ertificate of O u ancy: �
TOTAL: � . .
�
ewed/ pproved: DepL of CommuniTy Services F ece v y •:��ro�s�. m��