HomeMy WebLinkAbout0182.97 Application Carmel- lay PermitN�o.1 l. � ��/,y'��
=�p Application for � nac�_y5��- c� �
• Improvement Location Permit Roll File/ ! ` " �
This pertnit is,velid only if consWCtion�is stxrted within 120�deys of issuance date;a(I consiruclion must be completed(c/o issued)within�2.years of issuance,
date unlessan eMension of time�has bcen o�ciall- ranted b letter b .the Director,De artrnenfoCCommuniN Services.
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BUII:DER �I B70 Z- c`7�� X :3 � z'Z S 3
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TENANT NAME
� (if a lice6le
- unme � exoHe enx
OWNER � �
SRtEET CITY STAIE tiP
LOT nSUBDMSION SECIION
LOGATION r Q�
ADORFSS OF CONSfRUCfION
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A TYPEOF CONSTRUCTION o plans'incliule a porch? F. 1'YPE OF DYIPROVEMENT
1. �1 Single Family ��l Yes❑Nq 1. � New Structure
2. ❑ Two Family 2. ❑ Addiuon Porch_Room_
3. O Mulu-Family Type of FouvJation: 3. ❑ Remodel ❑ Commercial Tenent Space
4. ❑ Couunercial/Industriel ❑C�ewlspace 4. ❑ Foundation Only
5. ❑ Farm �1Basemcot 5. ❑ Demolition
6. ❑ OTHER ❑Slab 6. ❑ Accessory Building
(SPecil'Y) 7. ❑ Swirruning Pool
B: SEWER: ❑ Garage Detached Attac6ed
1. Q] Public (N�eofSystemCT� ����,��t,Split YES _ NO �
2. ❑ Private S tic Tank,etc.) lood Zonea YES NO
C. WATER: ` I. Sump Pump YE&� NO _
1. � Public (Name of System N D P L o J '��9�. ManufaMured Trusaea YES NO _
2. ❑ Private(Well' `^
D. ZONIlVG: �—Z �K. Plumbing Contractor�,T. N�l�U�t-
E. ESTIMATED COST OF CONSTRUCTIO L R c�
(Excluding Land Value) 0 a � ��R ,j n mg Yr�eo�'#y� ❑BOCA or�CABO
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The undersigned agees that aiiy consinictioq reconstructio , argemen`t,ieloca'on;or alt�au pn of swcture,or any change in the use of land
or structiues requested by tius"application will,comply with,;and c to;all a licatile,laws of.�he�3tate of Indiana,and the"Zoning Ordinance
ofCa�mellndiana-1993" Zr289 anda�nendmen un er• of .C. 36-7 e[�� v�n _
( ) seq!General�AssemhlV�of ihe Stete of Indiana,and all
�n llL3... .
Acts aznendatory thereto. I fuither certify only kitchen,batli,1aundry,an oor drain�aie connect�d;to the samtsr�y sewer. I further certffy
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that the construMion will not be use r cecupied unf a.Certifjc jOc ancy"�ha�s�bee,n��i9aued by?t6e�epartment of Community
Scrvicea, Carmel,Indiana. f/��� ' ���'�� �'!th q�f�:�//�p,
C� /�Z�1'��'VJl� In"� ./rn. Q � � ���a
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� ,�]� /) F mg/Uuder��'a �o� e� A� P
Signeture of Owner or Au[horized Agen " "" T � � �rj, r � ��'V T
M U,r C�r l a �.o � ro s�z-2 , s��e F� �2g�
(Print) (Phone Number) / Pemtit{Square Fa�tage) ���
Sewer Capaciry Allotted `� � / � Inspection Fees: �Q �O
Plan Commission/B ket#: Certificate of Occupancy: � dO
T TAL: �D
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Revie ed/A" roved: .Dep[ ofCommunilyServioes Fce eceivedBy d:��emm�v9s
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