HomeMy WebLinkAbout0155.97 Application I Carmel-Clay Permit No. /S�-�j,
` To.�,� � Application for /Date Z 9�— /�
Improvement Location Perriiit � Roll Fild �
This pertnit is valid only.if construction is started within 120 days of issuance date;ell consVUCtion must be completed(c/o�issued)within 2 years of issuence,
d'ate unless an extension of[ime has Lroen ofticiall . ranted b letter b the Diiector, aAment of Communi �Services.
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ADDAESS Oi CONSIRUCIION / �.�
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A. TYPE OF CONSTRUCTION Do plansinclude a porch ? E TYPE OF Il1�IIPROVEME
l. ❑ Single Family ❑Yes�.No 1. ❑' New Structiue
2. � Two Family 2. jd Addition Porch�Room_
3. ❑ Multi-Famity Type of Fcundation: 3. ❑ Remodel ❑ Commercial Tenant Space
4, ❑ Commercial/Industrial ❑Crawlspacc � 4. ❑ Foundation Only
5. ❑ Fertn ❑Ba�ement \ ( 5. ❑ Demolition
6. �3: OTHER �Slab I�+�U 6. ❑ Accessory Building
.
(SPecify) /alU•rn. 1�-aa-;o Enc.ios I� 7. ❑ Swimming.Pool
B. SEWER: � 8. ❑ Gazage Detached Attached
1. ❑ Vublic (Narne of System k� � � l '`�T lif YES _ NO _�
2. ❑ Private(Septic Tank,etc.) 1_ 1 ` , 4-I� nea YES _ NO _�
C. WATER: � d. Su ump YES _ NO X
• 1. ❑ Public (Name of System F anutactured Truases YES _ NO �_
2: ❑ Priva[e(Well F�j
D. ZONING: � �8 bing Contractor l�� �/1
E. ESTIMATED COST F CONSTRUCTION �,99
(Excluding Land Velue)�/2� O v v, c�c> > Plu bing Licenae# ❑BOCA or❑CABO
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The undersigned agrees that an;�'coustraction,reconstruclion;enlarge t,re etion,or altera[ion of suvcture,orany chenge in the use of land
or structwes requested by ihis application will compty with,and conform to, 1 apP�,cable laws of the State oF Indiana,aad the"Zoning Ordinence
of Cazmel Indiana- 1993"(Z-289)and arttendments,adopted under authonty of I.C!�36=7/�ef;seq�Crn jr��Assembly'of ihe Siate of Indiena,end sll
Acts amendatory fhere[o. I further certify that only kitc:heu,bath,7aundry,and tlfloor�drai 1�arn conn�ec[ed�o�the�ssm�};�Se,Rnq l further certify
that;the rnnsttvction will�not.be��used or occupied until a��L'ertiftcate ojO�cupan����s�een'tistued byt�e Depadme�3 of Community
Services, Carmel,Indiana � �QP! � � � Q!� �g
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Signature of Owner or Authorized Agent . IQA�,� �- '
T S 7cj (o3oG Site ` - /0 �
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(Print) (Phone Number) Permit(Squaze Footage)
Sewer Capacity Allotted Inspection Fees: �
Plen CommissionBZA D eP#: Certifica[e of Occupanc': � ��
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Reviaw'" ppro ed: ept.ofCommunityServices F eceivedBy ���me m��
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