HomeMy WebLinkAbout0164.97 Application el- lay Pemti[ No. y�
«ns�iip AppGCatlOn for' Dare 3��
�� , Improvement Location Permit �Roll File
TBis�pertniNis valid only.if�construcuon is stnrted within 120 days of issuance date; all conswctian is completed (c/o issued)within 2 years of
'issyance-datcunless°an extension of ome�,has been otTicially grented by Ietter by ihe Director, Department o[Community Deyelogment.
�N E � PMONE FA% `
BUILDER' �er�.itY �tKW"� ��J-�(.��i�_�' $-'7 —�.cl�n�
� �STREEf' CIfY STAIE 2IP
�G`�`� ..�ue r 'R '�'v a 'IbZYO
TENANT NAME
�(if_applica6le}
� � NAME PNONE FA%
O W NER
STREEf / CRY STATE ZIP
�
LOT' SOBDNISION SECTION
LOCATION O.� C/UGf✓
ADDRESS OP CONSTRUCf10N'� ' /� �
.. � �. L-:C � . ci^�' � 61 P 1J�� . . , .
A. TYPE OF 60NSTRUCTION E. TYPE O�'vIMPROVEMENT
� 1. ❑ 'Single Family. � �� � l. �New Struanire
2. �Single Family'Clus[er � 2. ❑ Commercial Teaanb Space
3. ❑ Two Family �/� �� 3. ❑ Addmon Porch _ Room _
4. ❑ Mulu Family ���� 4. ❑ Remodel
5. ❑ Commermal / IndusVial � 5. ❑ Foundauon.Only
6. ❑ Farm �� 6. ❑ Demoli[ion �
7: ❑ OTHER (Specify) 7. ❑ Accessory Building
B. TYPE OF SEWAGEeDISP.OSAL 8. ❑ Swimming Pool
� 1. E�Public System (Name;of=System CArv�,I b 9. ❑ Garage Detached Attached
2. ❑ Private (Septic Tank, etc.) G. Lot Split YES NO�
C. TYPE OF WATER H: Flood Zones YES NO �.
1. jYEubliq System (Name of'3ystem. �-r I. Sump Pump YES _� NO
2. ❑ Private_ (Well ' . - J. Manufactured"Trusses YES �NO
D. ZONING;CI:ASSIFIC TION OF P PE�� K. Plumbing CODE BOCA or CABO
Presed6 , � - � �
B. ESTIMATED COST OF CbNSTRUG . ��J � Plumbing.Contractor Nrs51o�-/
(Excluding Land Value) '1-'1'I 99 Plumbing�License N �i'_-P_1C> Z30�6�
The unders�gned agrees that any cousWction,�reconstiu ' n; enlar rnt;relocation,or al[eration'of structure;or sny�ehange in[he use
of-land or sttuc[ures�requested by this application will.com w` ,�and conform�to, all�epplicable��.laws.of Ihe State oftIndiana, and the,
� "Zoning,Ordinance of CSimel�Indiana-- 1993"`(Z289).aud��am dmen[s, adopted under�auttioriry of�Ac[s of 1979,'Public'Law:.l"7&�Sec..
1 et-.seq, General Assembly of the State�oEIndiana, and all Ap[sramendptory [hereto.
I.furtlier certify that the constructlon�will not�be uaed��or•occupied until a Cenificn[e oj Occupancy�hae been issued by the
- �Department��of Co � Development, Carme Indiana� � � .
I further oenify .oaly tchen, 6ath, laundry;.'a�� r drains ar � ected [o the sanitary sewer.
. - � � ooHn j� — .. ough=l Meter.�Base �.
�Si ature of�Owner;or,Au[horized Agent Inspec[ions.Needed {� � `� ��,��
-� � Drai����� ,?�" .S�te �inal C/O
� N• �' �C1/ � ..t,
� �.�tcr 1 A�i1�qr- �f`r.-
Address - Plan ��(��e�eimtt(f,BQ,`���,,o6�E,s�,e)� (obAO 'Z�nS�
L Gomm�js�on /,��'��',,:1.-''aG :l GJ�G�y° .
��r,�15 ��N y��v 2�(3-�%3i7� `�yp��iDocket"#��".��In@1�c�1aMF�es 2SO,0o
Ciry � � State Zip Ptione (L� G<�flv�`°'.°�� ����� G��
, � - ����������e,' �:ofOcc �ncy
Sewer�Capaciry Allotted ����
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Depa ent of Coinmuntiy Developmen[ Received by ��°"id1'�"��"�