HomeMy WebLinkAbout0183.97 Application Garmel-C,llay Pem�it No
��;� Application for Da�e �j' � , ��3 9�
Improvement Location Permit R°u F� e
This�permit is valid�only i(construction�.is sfarfed within I20 days of issuance�date;all consWction must be wmpleted(do issued)within 2 years oLissusnce,
date,unless'an BMension of time has been�otTiciall ran�ed b���letterb the Director,De artrnent of Communi Services.
NAME PHONE FAX
BUILDER D�SG�./�1 Rel"l�.[�1 573-'T33 '�
Se� W:. _l ZG`" z�-eo.�Sulc:.,�" V U-� �A� d Go77
TENANT NAME S
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DwNER S T .l (Cc �c�- � N
S1AElT CRY � SfATE lJP
Z?3t P3 GT: G�.�. �16o3Z. �
�LOT' 3l1BOMSION SCCItON
LOCATION 3 Z ���� �4' � 1��
AODAES4'�OF CONSIIIUCIIOt: '
� - 1
2� 1 �A
A. TYPE OF CONSTRUCTION Do pl E OF IMPROVEMENT I,
l. H�Single Family � �❑ New Structure ( 4 19� '
2. ❑ Two Family 2. ❑ Addilion Porch_Room
3. ❑ Mulli-Femily Type ofFout� '�fl� 3. �" Remodel ❑ Cotnmercial enent Spa
4. ❑ Commercial/Indusuial. �Crawls� , � 4. ❑' FoundatioaOnly �
5. ❑ Farm Ja$asemcr.� 5. ❑ Demoliaon
6. � ,OTI�R ❑$lab 6. ❑ Accessory Building
{Specify) 7. ❑ Swimming Pool
B. SEWER: 8. ❑ Garage Detached Attached
L �Pu6lic (Name of System � C �0„ G. Lot Split YES NO _
2. ❑ Priva[e(Septic Tank,etcJ H. Flood Zouea YES _ NO _ i
C. WATER• I. Sump Pump YES _ NO =-- �
I. �PubGo (Name of System �x�� / J. Manufactured Tnisaes YES _ NO _ �
2. ❑ Private(Well
D. ZONING: S�� � K. PlumbingContractor GAit9L�2 P�.✓�+[��N4 .
E. ESTIMATED GOST OF CONSTRUCTION .
(Excluding Land Vulue) { 3_vao Plumbing License#QB9�n5� ❑BOCA or❑CABO
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The uudersigned agrees that any consiruction;reconstruction,enlazgement,relocation;oralteration of swcture,or any change in ihe use of land
or siiuctiues requested by tttis application will comply with,and conform to,ali applicable laws of tt�e State of Indiana,and the"7_,oning Ordinence
of Carmel Indiena- 1993"(Z-289)and aniendments ted under authority of LC. 36-7 et seq;General Assembly'of the Stete of Indiena,md all
Acts emendatory thereto. I furthercertify that o y ba�h,lamdry;end floor drain�aze connected[o[he sanilary sewer. I further.certlfy
t6at the rnnstruMion will notbe used'.or cupir.d u ` Certifrcate ojOccwpancy has been issued by the Department.of Community
Services,�Carmel,Indiana .,
• ��' �"n�f Inspections Needed:
� 0�99]� Footieg/Uuderaila ough- - Meter Base
S� ature of Owner or Au orized Agent
Site inal G 1
-�.ta t'�_ 3R�cor.eC S�3- �t33 S� °� ��o�� ��
(Print) (P ne Number) ��= .Z SS Permit(Square Footage) �Z
Sewer Capacity Allotted �f4� �� Inspection Fees: ��O
Plan Commission/BZA Dochet N: Certificate,of Occupancy: `� �
OTAL:
- ��� �'� '
Rev' w ' ro t. ommunity Services F eceived By �:��ah. ���