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HomeMy WebLinkAbout0170.97 Application C el- lay PeimitNo. �b .�� o�t,;P Application for �ac� ",�� s � � ' Improvement Location Permit Roll File This pertnit is velid only if wnsVUCtian.is slarted wittiin 120 deys of issuance date;all construction mus[�be completcd(c/o�issued)within 2 yeers of issuance, date unlesSan extension of time has�.been otTiciell ranted b .:letterb the Director;De artment of Communi Services. NAME PNONE FAX $U�ER - �' ,�� �- �a3- s�� SfIIEET Cl1Y �TTA'IY ]1P ? — — �✓ ��� •c/. �G;�3 TENANT NAME (if e licatile xneee /J exoNe rnx OWNER SL7MF . SII{EEf CffY SI'AlE LP LOT SUBDMSION SEC170N LocnTiox " � ADDRPS4�oF COrmtUCnoN .J � .Cl Uit/,�' A. TYPE OF CONSTRUCTION Do plans include a porch? F: TYPE OF D1IPROVEMENT i. �-Single Femily ❑ Yes O No l. �New Struc[ure 2. ❑ Two-Family 2. ❑ Addition Porch_Room_ 3. ❑ Multi=Family Type of Foundatio • 3. ❑ Remodel ❑ Commercial Tenant Spece 4. ❑ Commcncial/Industriel, OCrawlspa� 4. ❑ Foundation Only 5. ❑ Fatm ❑Basement � 5. ❑ Demolition 6. ❑ O'CHER ❑Slab �� 6. ❑ Accessory Building (SPecSY) 7. ❑ Swimming Pool B: SEWER: ��, �� ❑ Gazage Detached Attached 1. � Public (Name of System eAR M f(, ) �� G. lit YES _ NO _ 2. ❑ Private(Septic Tank,etc.) ��H. nea YES _ NO _ C. WATER: !��• Sump Pump YES � NO 1. �, Public (Nazne'of System CRR�'�1 f--L ) J. Manufactured Trusaes YES _ NO _ 2. O Privat Well 1 I 1 D. ZONING: � � K. Plumbing Contractor��S,s/GN /��uM/�/dl(j- B. ESTIIYIATED COST OF CONSTRUCTION (Excluding Lsnd Value) I.�C�I� OOO � Plumbing License#IG .�.3 G(o ❑gOCA or❑CABO #***#trt*ttt�tyrtwrttrtiitt+stt**tt►t►##rtrtYf4}#***rt►tttrti#rttrtMt*<�##44ittttti#ttiOtli►*t4iii►ti►iiiitYt�iit►tRii _ The undersigned agrees that eny construction,reconstruc4on,enlazgemen[,relocation,or alteration of sweture,or any change in ihe use of land or swctwes requeste�l by this application will comply with,and wnform to,all applicable laws of the State of Indiana,aud the"Zoning Ordinence of Carmel Indie�ia- 1993"(Z-2S9)end emrndments,adopted ority of I.C. 36-7,et seq,Genersl Assembly of ihe State of Indisna,end all Acts aznendetory[liere[o. I 1'ur�her certify that only ' :en,bath;laundry,: oor dra�i d��e��ted ro�the sanitary sewer. I further certd'y that-the.couatructloo will oot be��.uaed or occ ied_until erfificate ojOce ��aiay.yh b`een-isaue A� aRment of Community Servicea, Carmel,Indiana. � � P�; : ������`�a� �, .� � �� � ���-g--��� �t- � � �j� � - C(l . , oot � der�s�lab���o}i�Ia Mete�BaiegyQt 9 . Signeture of Owner or Autho '� Agent �' IT� (�� t��Qp — _ Site�r n A i rF�f� �' ��r,�� I�JA��sn � rr+ . �a},s�?h `� � - �,v� `(�Print) (Phone Number) Pemtit(Squere Footagej � � 0� Sewer Capaciry Allotted . �/�R Fees: �� �Y 'g>p,,�,,_ > � Plan Commiss' Z.A ocket#: t�8t�iicat�of Occupancy TOT � �� \ view Approved: Dept.of Community" Services Fee Recei ed •:�+�em ���