HomeMy WebLinkAbout0173.97 Application � C�ay' Pernut No
w�st,;p Application for � Dar� � ,
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''"� I`nprovement Location Permit: -� Roll Fil
This.Permd is"vslid.only if construction�is started.within l20 days of issuance.date;'alf wnstruction.must be completed(c/o issued)witlun 2 years of issuence,
�date:unlesseneztensionoftimchaslieenofficiall�.. ran[edb .leUer�6�-UieDirector,D'e itmentofCommuni Services.
NAME �PHONE� FAX
BUILDER N /L � I7 - � -' -Ul � � - -
... - .. .. . srrseer� � cro srare ar
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TENANT NAME
� ifn�� licable . _
NAME � �'PHONE FAX
OWNER
. . . SIREEI'. CRY SfAIE ZIP
� LOT SU6DMSION SECTION
LOGATION �' ' � . �
ADDRES4�OF CONSfItUC110N
r��8� ��h�u,� ���- C.� ��
' A: T'YPE 1 CONSTRUCTION Do plans,include�porch? F. 1'YPE,(jF''IMPROVEMENT
1. Single Family ❑Yes Q"No 1. �� New Structure
2. ❑ Two Family 2. ❑ Ad`dition Porch_Room_
3. ❑ Mu1ti-Family � Type of��' undatioi�: 3. ❑ Remodel ❑ Cominercial Tenant Space
4. ❑ Commercial/Industrial ,QC�vlspace 4. ❑ Foundation Only
5. O Ean� ��ssemcnt 5. ❑ Demolition
6: O QTFIER ❑Slab 6. ❑ AccessoryBuilding
(Specify) 7 ❑ Swurmung Pool
B. SEWE� �° Garage Detached Attached
1. Q" Public (Name'ofSystem �'r� �����[��tit: YES _ NO
2 ❑' Private($eptic Tank,etcJ ��r H. Flood Zones YES �NOO � `
C` ..WA,_,_,:� CPYiY ?"r"�2 8 �Q9�ump Pump YES
i c3r
l. E�' Public (Naine of System .��� anufacturetl Trusaes YES _ NO �
2. ❑ Private(W f
D. ZONING: �`— K. Plumbing Contractor T r t �nhev f/i;r�binr�VC.
E: ESTIMATED CO T OF GONSTRUCTION
(Excluding Land Value) �n� .171� - Plumbing Licensc# �fln 5(�29R�❑BOCA or O_GABO
sat�s*irrisrs=s*�**�si*tss*►*r� itRfi#Rti#�F.#t#tlittt*#*rt#it##i##ittrtrtKi�k�#itilk#ii�ktF#+Fttrt�tiKff+tttiiittiiiit
The;undersignedagrees thAF'eny wnstruction;reconstruction;enlargement,relocauoq or;alteration of structure,or any change in the use of land
A
or stiuctures requested by this application will'comply,witt�and conform to;all apphcable laws of the State.of Indiana,snd the"Zoning:Ordu�ance
ofCarmel Indiana.-1993"�.(Z-289).and��.amendments;,adoptecl'under au[horiry�oPI C7�`6 7•Tet seq,Genei-al Assembly ofthe�State of Indiana,end all
Acts��amendatory thereto. I-fiiwthetcertify thaf only kilchen,bath�,laundry;and floor drauu ue conn�ted to the�senitary;sewer. I further;certif'y
�'r-t.o - �v9 ��tv-.�.��bv.z.�
ttiat`the conatruction wi11 noYtie used or-occupied,until'a CerkficrUebjOccupancy haS'�beed�P�by;t6e�DepartmenV of Community
Services, Ca el;Indiana 7XFq�i����ps¢ , r `' ` �
. , �.� (}n �-�6SEIC� .n.S� �C11Ct�: �QIfQAt.i
�1�VY p '�odes
t6o in' �ef1�3b u�'111�T.�Baee
ature wnen r Authorized Agent ��J(j ^
(Y/n 77 8� \,ite��� � P � �� C/O�l �
(Print) (Phone"Nuin Permi[(Square Foota 2' f-! � �C�'
Sewer Capacity Allotted___��/ .. �Y eclion Fees: �Q_G�'�
Plan Commissio" ZP.Da.ket;#; MAR �,S 199j 'C icate of Occupancy , ,���
' / .�\T T . O�d
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` � i ed/A rov : D.ept:of Community Sernces Fee Recei By ���� ���