HomeMy WebLinkAbout0174.97 Application �(���ieIl�Iay, Permit No.
�j ��p Application.for �jDate�`,'��'%q�
' �;. " Improvement Location,Permit U Roll File i �
�This�pertnit is��validbnly��if wnsVUCtion is started within 120 deys�of issuance'date;�all construcliommus46e wmpleted(c/o issued)within 2 years of issuance,
datc unless sn�estensiodof time has tieen�official( nted b �letter,b Ihe Dikector,De rtment of Communi Services.
NAME :PHONEI 'FAX
sun:nEx �r��n � � �
5'IREEI'� . CITY SfATE ZIP
N� N
.���IicaEl �
' NwAfE PNONE FAX
owrrEx � .�iet� ��a�/�� . .S� — �G S"�!-9 's�
.1"IREET� .. CffY . . STA'IE �lP
��y2:� �SJ`F k L-r. �r.�-��� Z'.✓ `i�G��3
� :LOT - � .SUBUMSION _ S ON
LOCATION
' tADDR2S5 OF CO UCIION � ����' ' • ✓/ •
A. :1'Y?�OF CONSTRUCTIQN Do plans include a porch 7 F. TYPE OF;Il1iPROVEMENT
1. Single Family ❑'Yes❑No 1. ❑ :New Sfructure
2. ❑ Two Family 2, ❑ Additiou Porch Room_
3. ❑ Multi-Family Type of Lquudation: 3 ❑: Reinodel ❑ Commercial Tenant Space
4 ❑ Commercial/,Industrial ❑Cracvlspace 4. ❑, Foondation Only
5: ❑ Faim �Basecuent 5. ❑ llemolition
6. �, OTHER" ❑Slab /,,� 6. ❑ AccessoryBuilding
(gpecify 3 f'-C l �,X � lY 7. ❑ SwinnningPool
B: SEWER: �, � 8. ❑ Gazage Detached Attached
1. ❑ Public (Nazne of Systam ) -" G. Lot$plit YES _ NO
2. ❑ Private(Septic Tank,etc.) �� H. Flood Zonea YES _ NO
C. R'ATER: � Sump Pump YES _NO
l, ❑ Pu6lic (Narne of System �� �.� ufactured Trueaes YES NO
2 ❑ Private(Well 2
D. 'ZONIlVGi ' �J9�. PI ingGoutractor
E. '�STIMATED COST OF C�N TRU TION
(Excluding Land Value � Plumbing Licenae# ❑BOCA or O GABO
'#rt#*f#reet+Frtttrtw#i#### MR#/ t#Yik*I#I*#iit►itrtt#tat+#tst#*#tti*�t��Rt�:F#rt#rtetttiV►t\t# iifi#itittitiftt#tRttt
The undersigned agrees that any-construction;reconstruction,:enlargement,relocalion,oralteration of suucture,or any change in the use of land
or shvctwes requested by tttis applicatiom:wi]Lcomply with,�and confomt to,all applibable laws of the S[ate of Indiana,and the"Zoning Ordinance
oEGazmel Indiqna- 1993".(Z=289)�.and'amendments;�adopted under authoriry of I Q.36-7 'et�seq,General Assemtilybf lhe State of Iniliana,and'.all
Ac[s amenda[ory thereto I fuiYher ce�tify that onlykitchen;ba[h;laundry,end floor,drain,aze connected to the sani[ary sewer: I further.certity
:.- . . -
that;the coustructioq will'not be used,or occupied until a Cerkficate ojOccupancy has been issued by the Department-of Community
$eryices, Carmel,Indiaua
--� Inspections ded:
' �/�y`u'"' Fop�fn-., derslab� Roug6-In. . eter Base
�ature of Owtier or Authonzed Agent :
�° '�Srte � :., .`. � C/O
��'b Y����, ��.a
(Piint) . . . (Phone Niimber) �I'.�iu����ge) . OD .
���aA f�.. � ,� �
Sewer,Capacity Allotted ' N�A f�'� ,a,G b 4B��s: 0 ��: �'�,fi *
-�--T--- r, > ,
ti <� G �
Ylan CommissionBZA Docket#: ��R fr��� J��e t`�c�f Occiupancy: �5.00 J J9,�
� �^�' e i✓. � \v` �
� ati. ��d �� �
Q'`''�a c���° Q�O�.
�,_ .
� � � G
Rediewed/App ov�. Dep�— ��� �� 4� � �
� "` � of Community Services �\.t't Fee Rece B. .:��sm mi�
I� � � n, �
�%