HomeMy WebLinkAbout0187.97 Application �C_ el-Clay PermitNo. �J
�o� Application for � Da� 3- � ��/
ImprovemeHt Locatio�,Permit Rou F�,
This�permit is'valid only.if wnsiruchon�astaited within 120 dnys of issuance�date;�alf consttuction.must be.completed�(c/o issued)wittun 2 years of issuance,
�date�unlessan.eatension�oftimehasbeen�ofliciall� rantedb letterb�:tfieDifector,De artmenYofCommuni .Services.
NAME PHONE FAX
suu:nEx f',� � C, �r 5 2-24:� 3 5BZ �Z _S.3
�SIREEI'� . CTIY .STA'IE ZIP
IC� �v. �/'+' S-fr,�� Ca:v m � .L�% 6 p: .
TENANT NAME
if a�licsble)
xatie exoxe F�
owivEx S R'M G
. . � STREEI' CIIY STAIE ZJP
LOT-7 �7�SUHDMSION SECIION
LOCATION �j r 0.�'� w��(� Z
ADDI2ESS�Oi CONSfRUC110N�� �
Z �'r -l!1 f
A TYPE'OF CONSTRU�CTION Do plans!_include a poic6? F. TYPE OF IMPROYEMENT
1. ,�J Single Family �Xes�No 1. �I New'Structure
2. ❑ Two Family 2. ❑ Addition Porch_Room_
3. ❑ Mu1ti-Family Type of Foundauon: 3. ❑ Remodel ❑ .Commercial Tenant Space
4. ❑ Commercial/Industrial� ❑Grawlspu;z 4. ❑ FoundationOnly
5. ❑ Farzn 6�asemen � 5. ❑ Demolition
6. ❑ OTHER t����� 6. ❑ Accessory Buildipg
(Specify) ��'" 7. ❑ Swunming P,00l
B. SEWER: 8. ❑. Garage D'etached Attached
1. `�1 Public (Name of System ►�✓D R 0 5199� G: ��sP�t �s NO ��
-2. ❑ Private(Septic Tank,etc) � H: Flood Zones YES NO �
C. WATER: I. SdmpPump YES � NO _
L �1 Public (Name of Sy N D P L.. � ManufaMUred Trussea YES NO _
2. � Arivate'(Well
D. zormvc: S � I &y., qR 1�� n�g cont�BMo�Q .T: N10 o r L.
B: ;ESTIMATED COST OF GONSTRUCTIO_, '99T (! P��005Z DS
(Excluding Land Value) � � �, � Q� P umbing License# ❑BOCA or�CABO
�st�tst*t*+aww*w***raat+ss�rrirrss**sss**s*�t+sst* ttstss � t+**�*st�*t*rrx*►sstssstt�asssttstaasssryarra�x
The undersign8il agr8es that any constivction,reconstructiou,enlargem , ocation,or alteiation of structiire,or any change in the use of lend
or;shuctures requested by this application will comply with,and conform to,all apPlicable 1�s,of tlie State of Indiana,and the"Zoning Ordinance
of Carmel In�ana:-1993".(Z-289)��.and'amendmenEs,�,adopted ' of-I:C..36-7� et se'y;��neral,Assembly:�of the State of Iudiana,and��all
Actsamendatory�thereto. .I:fwther;certifytha[only� �- en,�b�undry,�an � oordra"�+araconiie.`�ct��to�the��sanRer.ypsewer: I furthercertify
. J A t/S ..�. � t �ilI1T
thaE;the rnnstruction.will not-be used,orocc ied until a emfua/e ojOc pncx:.has��een<uau�b��6e Departmenttot�Community
Services, Carmel,Indiana `� "°qlf,I�- �` C�'Wa¢/y n/ �U�l
���-�� � -� � IlN+'�KS+3�� .� pC4/�Pt�f3Pinr),+
i (��
. , . . . � .. - g �✓��� �' "1n.A
q ��� rY
�f%M F � nde I�Y�CSirg6 in =�ster�Base-.dJ-
S
ignature of Owner or Authorized'Agrni �Q A��
� Site Final r J� o ���,,
M�rC�,I-T r� ZDVV��vU S�f�Z-Zq-5� x 3� � ��� , �
(Print) (Phone umber) eraut(S,quare Footage) __L'.L2�
Sgwer Capacity.Allotted _ _ Inspection Feesi ���
Plan CoaunissionB ''Doeket#`.' Certificate oF Occupan "i �� ��
T � I �fi
�
i �
Beci�a�e Appto Dept.-oECommunityServices FceReceivedBy �:��a�+ m��
�