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Home My WebLink About0167.97 Application Carmel-Clay Permit No:' �ownsh;�: Application for � Dece_��7� '(�1'�,�\ Irraprovement iocation Permit �ll Fil , � Tfiis�permi6is��,valid�only�ifconstructiomis started:within��120 deys�of issuance date;aIl consWction must be.wmpleted(c/o issued)wiUiid2'.years of issu9nce; dste unless an�eztensionbf time�has.been oRcial) ranted b .letterb �the Director,De ent of Communi Services. � :NAME PHONE FAX suu.nEx S -Z_ 3 S z� Z' 5 3 SRtEEf. ClIT� STATE 'TJP .. . � S r,� r � — `��03Z TF.NANT NAME �Cifa licable),'� - . �HwME 'PHONE FAX �OWNER ° � �� SIAEEf CITY StA'fE lJP � LOT SUBDMS�ON- SBCIION LOCATION a P�S�DV.I 2 ' qDDRASS OF CONSfk^UCi10N . '. �. . .1 W I ` .., A. 1']'PE•OF CONSTRUCTION. Do pl include-a porch 7 F. 1'YPE OF IlYiPROVElYfENT I. l� Single Faauly �Yes O No 1 �.�New Structure 2. ❑ Two Family 2. ❑ Addition Porch_Room_ 3: � Multi-Farnily' Type:of Foundatio .� 3. ❑ Remodel ❑ Commercial Tenant Space 4. ❑ Commercial l:Indusvisl OCra�vlspace ��4. '❑ Foundation Oniy 5. ❑ Faan �Ba�ement /' �f��❑ Demolition . 6:. ❑ OTHER ❑Slati, Y!�+} ` G,�! AccessoryBuilding �SP��,S') �G '� 7 r g Pool B. SEWER: I�,99� Garage Detached Attached I. �H. PubGc (Name of System��W� -) G. Lot Sp6t YES N� 2. ❑ Private(Septic Tank�etc.) H. Flood Zones YES NO � C. WATER: L Sump Pump: YES � NO _ I. �1 Putilic (Name of SystemTl��,p�Sj, J. Manufactured Trtisaes YES �� NO 2, ❑ Private(Well ) �7 D. ZOIVIPTG: S — � K: PlumbingContractor I� .7• M'�� e� E. .ESTIIVIATED'COST OF CONSTRUC ON G�fJ I 0�5�D S (Excluding Land Value) Plumbing,Ircebse„ ❑BOCA or l�Q CqBO. .+k##*i#i#ikta�+ki####i#i4#►*#,iii�+#*##et#tt►##►t<#i#t#ttrtrttei#►i!*#it►3i4##trt#krtY+k#+F*rtrt###i#rt**ttt+ktii*ti►tf#it The undersigned agrees that any:construction,reconsWCtion,ecilargemetit,relocation,"or alteration of structure,or any chatige m the iise of land - orstructures n.quested tiy this application will comply with,and conforin to,all applicable laws'of the'State of Indiana,and the"Zoniq`g O�dinance �of Gazmel Indiena�,- 1993"(Z=289)and-amendments;�'� ed;nndzr.autho � -of I C.36-,7� eL seq,General Assemtilybf[he State of�Indiena,.and.all Acts-.au�endatory thereto. I,fuither certify that y�kitckien,batti,laundry,.en oor.drain�are�connected�to the sanitary..sewer. I;furt6er certify� e..+S a r p:. tLaf the constraMion will`not be`used` occu �ed u il/q�'',Cer6fic Oc poncy;6as-been•�ssued.by�t6e Depar[meot+ofiCommunity Services, Ca�tnel,Indiena /� /j/j/�j�/�/�� ,�5�', rq p /�^ -' l/t'f 4.i��c.'.T��e7��! V _ !✓(!"'"Y /Y�� SEl.awrAx° /Y-in �' y. � �rIns -E' ns•NeeBed:�� . � + �p�^ lQed�. , -� �� .�r�.�ra&y,�a�a�l � � „ ��cad a,��._� /? .Q/, . ntlers^Iab�Itd,ug�-in�p CIMeVLI(}P(��'�1I' ignature of Otvner orAutfionzed Ag"ent = ""� (�� c _ � t - 5ite FlalY ; �+prlQ' / Nla�c�:11,c� � ovv�-e ✓� 5�42-z�-s�x39°i ' ��n�� r :-, � , ,,a��=��', (PTiiii) (Phone Numb ) Pe� _($quare�F r / U�� SewerCapaeity.Allotted� �� ' � � �� InspectionFees:�� "� � �" . .�. . C9� PIan ConunissionBZA Docke[#: �\Certificate;of Occupancy, ., � Op `�' � °��99�' � .: � R APProved: Dept of Community Services � � �ee'R' ived y •:�.�v�aa�. m��