HomeMy WebLinkAbout0178.97 Application �y . . Perinit No. � 0
�,'�,, ,;; Applica�tion for �a1e
%" Improvement Location Permit '+" xoll File
; pertnit is valid anly`if:conswcu'on is sturted;withia 120�deys of issuence date; all conswction.is complcted (c/o,issueA}wittiin 2.years of
�nnce date unlcss.an extension��of.ume has.been o�cially grented by letter by the Dircemr, Depertment of Community Development.
.NAMP' � PHONE � FAX
BUILDER, 57 -6 Sb -6`36 -
� STREEf � CT' STAIE 2@ ,
. 8�55 ,U, lVef �1 n � ���s .i� L(6
TENANT NAME
i� ,
, (if applicable) .
NAM2 PNONE - FAX
O W NER /
�STREEf C���� . - STATE ZIP
IAt SUBDIVISION� i SECf10N
LOCATION � �-+�+-��� '^ � 1���
_- _
A�DRESS�OP CONSTRUCTION
l l20°i" Sc�.� . �
A. T�YPE OF CONSTRUCTION F. TYPE O ROVEMENT
L j� Single Family' ���� _ L New Structure
2. ❑ Single Family'�Cluster /�� 2. O Comm,ercial Tenant�Space
3. ❑ Two Family 1 1, � 3. 0 .Addition Porch _Room _
4. ❑ Multi-Family 1 � 4. ❑ 'Remodel
5. ❑ .Commercial / Indusvial 5. ❑ Foundation Orily �
6. ❑ Farm, 6. O ,Demolition �
7: O' OTHER(Specijy) Z ❑ Accessory Building !
B. TYPE'OF SEWAGE DISP.OSAL 8. ❑ Swimming Pool
„ l. L]':Public System,(Neme of�.System' L�T2W7 ) 9. ..❑. Gerage Detached -Attacfied ��
2. ❑ Private (Septic Taak„etc:) G. Lot,Split YES NO �' -
C. TYPE OF WATER H. Flood Zones YES NO �� -
� 9;, H�Pu61ic�System;(Name of'Systemti-�-����5 wc,�-crr) I: 9ump,Pu,mp� YES - NO i .
2.- ❑ Pnva[e (,Well . � . 1 J. Manufachred Trussee � NO
D: .ZONING CLASSIF�A�ION OF PROPERTY K. Plumbing CODE BOC _ or CABO
Present
E: ESTIMATED COST OF CONSTRUCTION Plumbing Contractor 0/`�
� �.(Excluding..Land�Value),. .6SyB"� PlumbingrLicense N � O. �
' The undersignqd agrees tkiatdany conswction,reconswction, enlargement,rel'ocation,or alteration of structure,or any change in the use
ofland�or�structures:reque`sted by•this application will comply wiih, and��conform to,.all.applicable laws of the State of,.Indiena,and tbe
'"Zoning Ordinance;of Cartnel'Indiana = 1993" (Z=289) and amendmen[s; adopted under authoriry of Acts of 1979, Public Law 178 Se6.
1 et seq, General Assembly of the State of'Indiana, and a14 Acts'amendatory thereto.
I turther��oerNfy �that the construction will-not be uqed �or occupied until a Cerrifcate oj Occupancy has been iseued by the
Department;of�,Community.Development;�Garmel, Indiana �
I fuither�certify that oaly�kitchen, bath, laundry, a tloo �drains are� ected to the sanitary sewer%~� .+;
. �..�.. . �� .
h < r�
. . .. : '. ... . __ ' • r 5�' ��) '
n nder Slab� ' ougti-In Meter Base �
Signatuce of Owner�or Authorized Agent In ions Need pv,;�� ,�'��"'vqy� �
� �Lq. � �.y� �ns�,�.•��:s�� . �� cio
85ss .J. Rw� �2a1. '�' , �,�°".d�.t�
� Addre=s �\ �E a a ��'��t�quare Footage) aq.Q7 20�
,/ ��Coaim��.t�on�1;.�.�, �� (�v�
�.nr�«-x�n-��.,5 � `E6711V 571I- �BZArpocketzfld��pc�i nFees �54.00
�`City State Zip Phone �,�i�0\ G44�G ���
,q \ � Qg �llertificate�of�Occupancy �J�.00
�\er Capaciry Allotted Vc�. �y �Q�1 � � O�(
Q� TOTAL � a.q�:00
�,..v. ciH.rin �
� Dep: �ment of�Communtiy Development Received b� �°�Riid1J°�19�
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