HomeMy WebLinkAbout0154.97 Application Carmel-Clay Permit No. l ���"� '
To�,,,,sn;p Application for �Date_� `f � ._
•' -`- '' Roll File
Improvement Location Perrrait .
�This permiM1is valid'only if construction is started within 120 deys of issuance date;.all consWCtion must be completed(do issued)within 2 years of issuance,
date�unless en extension of time has bcen oRciall rantcd b letterb� the�Director,De ment of Communi Services.
'NAME PHONE PAX
BUILDER � e,� 4 � 57f`- 7�f>�
. . EI' , ClIY /� -. �� STA'1E ZIP
/
/a-73�f -x �,l_to� �'
TENAIVT NAME•
(if a licable) ' .
NAME �RNONE FAX �
OWNER
SRIEEf CRY STA'IE ZIP
LOT SUB�D—M�5/10�y /�� SECIION
LOCATION l i'�L7�- vl�'LlG2l� �iL'1- /I Ci�v(i -��
MORFSS OF�CO�(N"�SfRUC110/N�� n ` / / // ,
� L' y '7 e! � l/ �v�
/
A. TYPE OF CONSTRUCTION Do plaos inc�a porch 7 TYPE OF Il�IPROVEMENT
I. �( Single Family ❑Yes No I. ❑ New Sttucture
2. d Two Family 2. ❑ Addition Porch_Room_
3. ❑ Mu1ti=Faaiily Type of f?owidati 3. ❑ Remodel ❑ Commercial Tenant Space
4. ❑ Commercial/Industrial ❑ rawlsp�r� 4. ❑ Foundation Only
5. ❑ Fazm esement � 5. ❑ Demolition
6. ❑ OTHER Slab � 6. ❑ Acces.sory Building
(Specify) � � 7. ❑ Swimming Pool �
B. SEWER: �` � ❑ Gazage Detached Attached
I. ❑ Public (Name of Syst � �, � , Split YES _ NO
2. ❑ � Private(Septic Tenk,e[cJ (Q r{� � H. Zoues YES _ NO �
C. WATER: �/ ,i'I. S p Pump YES _ NO
I. ❑ Public (Nazne of Systema n J. Manufactured Trusses YES _ NO _
2. ❑ Private(WgIl ���/{
D. ZONING: J � K Pli�mbing'Contractor .�l I f�
E. ESTIMATED GOST OF CPIy T UCTION 8i��ysyv
(Excluding Lend Value)�J��-��C9-� Plumbing Ircense It�a/�(9�i�[�iBOCA or❑CABO
ttsw+►sss**t*"tt+s*tsar►*rrrrtrrtrtr+�*sxrssrwrstr+rrWrs+�rsttssssssttt*sssissssss�r�srt*»ssssrassssrrr�rss»srssss
The tmdersigneA agrees lhat any consLVCtion,reconstruction,enlazgement;'relc�calion,or,alteration of structure,or any change in the use of lend
or shuctures requested by ttus application will comply with,and confortn to,all applicable laws of the State of Indiana,end the"Zoning Ordinence
of Catmel Indiane- 1993"(Z-289)and amendments,adopted under.authority of I:C. 36-7 et seq;General Assembly�of the State of Indiana,and all
Ac[s�aznendatory�there[o. I Iurlher certify tha[only ki[chen,.balh,laundry;and floor drain;`azebonneo[edto the�sauitary sewer. I further certffy
that the'construc[ion'will not be used or occup' ntil a Cer6fuate ojOccupuncy 6as beeu issued by t6e'Department of Community
Servicea, Camiel,Indiana
In,spections Needed:
� _ � � � FFB�� ,: ;
:.
ootin derelati� � ou'h- eterBas
Signatwe of Owner,or Authorized Agent ' j '"
9 �
�T7Z.�e; �1 I �� 57�-��' 9� /�e`r���G �., �y` ao
� G '�� ����` 14a.o0 9(�
(Print) (P6one Number
�Q'� c
Sewer Capacity Allotted �._p�,`�14q1 (;� � 5¢ ��� �
v 50.00
� �c�'�� � �.
Plan Commission/B'LA Dacket#: ��l�g�,`�o��`�y \ ccupency: "� . I 00
5`�O�e O�C'FUT � _ O .O
a,� . :� G�.� '
Reviewed/A proved: D'ept. of Community;Services Fee Reae �ed B} ) 4��m�+ m��
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