HomeMy WebLinkAbout0172.97 Application `�Eazmel-Clay Permit No. ��. -��
TowiYShip Application for � Da�
� - (` Improvement Location Permit RollFde
TFiis.pertnit�is yalid only�if construction_is��sterted within 120 days of issuance date;all construclion must be completed(c%issued)witivn 2 yeers of issuence,
'datc:uoless an eMension of time has been olliciall , ranted b letter.b �the Director,De sAment of Communi -��Services.
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BUILDER �vLO� .CLr�x.40� %�IC 3iJJ!9�oTP/o! t�/7�9�'�Pa1/
S:R�E1Ef C SfA'IE ZIP ,/
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TENANT N.��ME
� , (if e licable
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OWNER �� ��
SIREEf CITY STA'IE lJP
LOT SUBDIVISICN SECIION
LOCATION '^�� ��� ��� 6
nnoaes5 or coNrrnucnor+ �
9 T.�oo %��
A. TYP�OF CONSTRUCTIOIV Do plsns includ a porch? F. .TYPE F I111PROVEMENT
I. Single Fartiily ❑ Yes�1Vo 1. ^�New Structure
2: Two Family < 2. ❑ Addition Porch_Room_
3. ❑ Mu1li-Family • Tyge of Foun u � ❑ Remodel O Commercial Tenant Space
4. ❑ Commercial/Indusuial ❑Crawls ace � oundation Onl �
P � Y
5. � Farm ❑ asement / olition
6. ❑ OTHER � -�31ati �? 6. ❑ ccessory Building.
(SP,ecil'Y) r,�� ❑ SwunmingPool
B. SE�VF,R: 8. ❑ Gazage Detached Attached
I. �' Public (Name of System T �'✓ G. I:ot Split YES _ NO�
2. ❑ Private(Septic Tank;etc.) H. Flood Zones YES _ NO � �
C. W�R: I. Sump'Puuip YES NO �
1. Public (Neme of System J. Manufactured Truases YES � NO _
2. ❑ Private(Well'
D. ZONIIVG: ' K. Plumbing Contractor �T��o"/..P�
C. ESTIMATED COST OF CONSTRU TION
(Excluding Land Value) �9�� Plumbing Liceose DD 11�..�BOCA or O CABO
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"fhe undersigned agrees that any construction,reconstruclion;enlaigement,relocatioq or alteration of sVUCtute,or any change in ihe use of land
or shuctur�reqi�ested by this application will comply with,and conform to,all apPlicalile laws of the Sta[e of Indiana,and ihe"Zoning Ordinence
of Caimei Indiana- 1993"(Z-289)and amendments„adopted under eathority of I.C.36-7 et seq,General Assembly'of the Stste of Indiana,and all
Acts.smendatory.thr_reto. I:fiuther certify,that only kitcheq bath;laundry,�and oor drain,ere connected lo�the sani[ary sewer. I'further cer[ify
that the construMion will not be.used or'occupied until a Cerlifu upancy.has been isaued.by the Department of Community
Servicea, Cnrmel,Indiana
���99� Inspections Needed:
.�7� � �it+ZL� � � , � ndersl ough-In � eter.Bane
Signature of Owner or Authorized Agent MP "`�
3ite�.� ., , Finel GO
�L�vnh �c! ti/�;� ��;9�o?P ��• ���;�"�'.. . 1a� � '
(Print) (PhoneNumt+er) ��ql�e�[u'����p�[age) � �,`�.�� 341s
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Sewer'CapacilyAllotted �:t�(�. Iq,IQQ1���6t��0,���Q��s: aS��QD
�a�� ��J �'
Plan CommissionBZA Docket#: Q` ��� � of Occupancy: �.5�
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4 Qti �� �
Reviewed/Appro ed: Dept.of Community Services ���`� Fee Receiv •:�+�uvsa�. ��vsa
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