HomeMy WebLinkAbout0185.97 Application ���Clay Permit No
� R� Application for � nec�� ������
!i Improvement�Location Permit R°»F` '
.his pemiit is valid only�if canstruction is started within 120 deys of issuence da[e;all consWCtion must be wmpletcd(do issued)within 2 years of issuencc,
.date unless an eMension�of time fias�been ofiiciell . ranted 6 letter b �he Director,De ent of Communi Services. �
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` BUILDER i� e G�a Sd2Z�5 �x 34 �z— z¢$3
SIAEE? CTIY SfAIE ZlP
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TENANTNAME
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OWNER �
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I,OCATION �
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A. 1'YPE OF CONSTRUCTION Do pl mclude a porcli 7 F. TYPE':OF IMPROVEMENT
l. I� Single Femily �Yes❑No 1. $] New Structure
2. ❑ Tw�o Eamily 2. ❑ Addition .Porch_Room_
3. ❑ Multi-Family Type of Fouudation: 3. ❑ Remodel ❑ Commercial Tenant Space
4. ❑ Couunercial/Industrial OCrawlsp:!ce 4 ❑ Foundation Only
5. ❑ Fazm �,Basement ❑ Demolition
6: ❑ OTF�R ❑Slab ���� ❑ AccessoryBuilding
(SPec?fY) �i ��''' 7. ❑ Swimming Pool
B. SEWER: ��s° 99�g. ❑ Gazage Detached Atteched
l. $I Public (Name of Syste�J��'� � l ��R Q��. Lot,SpGt YES _ NO��
2. ❑ Private(Septic Tank,e[c.) �`U"' H. Flood'Zonea YES _ NO �_
C. WATER: I. SumpPump YES X NO _
1. ❑ Putilic (Neme of System Z N� P L J. ManutaMured Trusses YES �NO _
2. � Piivate(Well
D. ZOIYING: ' � K. Plumbing Contractor R•T• � 0 0✓�
E. ESTIMATED COST OF ONSTRUCTI N
(Excluding Land,Vnlue) (} �� MqR 1� mb�I.����#S 2�5 ❑BOCA or I�CABO
w+t•.�sksr�tss=*�iFif��*#rw�wa�rfs#i#. fstsss*rss►l���ssa� tti#►tW�tttrtrt►ttii!►i�i{if►wM*tiiiii�ttMitrttt4M
The undersigned agrees ihat any construction;recoastruc enlargement,rel ation,or alteration of swcture,or any change in the use of land
or strucuues requested by ihis application will comply with,and� to,a applicable laws of ihe S[ate of Indiana,and the"Zoning Ordinence
of Cazmel Indisna- ]993"(Z-289)-and amendments,ad under au C 36-7 et seq,General Assembly'of the State of Indiana,and all
� tvC) cq.._-.
Ac[s'emendatory�thereto. I fur[her.certify that o ��tchen;ba[h,laundry,and floo . auu are_coonected�to the sanitary sewet. I further certity
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that the�constFuc[ion will.not be used or upied until a Ce fuale o O� � `6ae been�ssuedfby�the,Departmeot of Community
Servicea, Carmel,Indiana �!! d j��� �1/ `�pllQllC� EV' '}u�,1i,.��
� //UG � �lOS ,�uu'acu�•-Ca�!' F',,?�¢'�,/2fFr '
� � /Jh � nI//j(//j ,4 n�,( ,� �� � /, ,., �r" YO�n��P� ��i, n C.00QI�'r,• .:;"�,,.,�
C�`��V�S�CXit� l I.E VIW/LCJ �jj�f� ���Sh-��EjMeterJ�CIV�
�gneture of Owner or Authorized Agent �
S��lAAl�m�- cio
�I r�r c�, 11 rn IZo i ,r -z�5 b�c 3�°J , , 9 , ��4�, _ ;
(Print) (Phone umber), Pernut(Square Footage
Sewer Capacity Allotted �. S � � Ins�ection Fees: � �52��
Plan C ssionBZA Dceket#: Certificate of Occup ���
TO `� ��
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'�-Revi w p of;Community.Services Fee Received By •:��ma ���
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