HomeMy WebLinkAbout0156.97 Application �a�leltiClay Permit No. �,I �f�
��ow;,s�;p Application for De��1 / �, 9� rt7� � �
Improvement`Location Perrr¢at � R°u F''e I 1
This pertni[is velid only if wnsWC[ion is started within 120 days of issuance dete;ell consWCtion must be comple[ed(c/o issued)within 2 years of issuence,
date;unlessanextension�of,time�hasbeenofTicisll . rantedb .lettcrb theDirector;DeartmentofCommuni Services.
NAME PXONE FAX
BUII:DER �T C T �/�ni� .ZNC • �z6-973
i� �,� � Lk� -�A� 5��2.�6
TENAN'I'NAME
(if a �licable
t+ntae rxoHe Fnx
OWNER .
SIREEI' CRY SI'A'IE LP
LOT SUBDMSION SECIION
LOGATION
A➢�APSS Oi LONSIItUCf10N -�;/
' W.�Q.�S � C��� -HV
A. 1?YPE,6F CONSTRUCTION Do plans include a porch? F. TYPE(1F IlVIPROVEMENT
l. Pf Single Fartiily ❑Yes No 1. �' New Swctwe
2. ❑ Two Eamily � 2. ❑ Addition Porch_Room_
3. 0 Multi-Femily Type of l o t on: 3. ❑ Remodel ❑ Commetciel Tenant Space
4. ❑ Commerciul/Industrial ❑ ra � 4. ❑ Foundaaon Only
5, ❑ Fazm �Ba,emen���, Demolition
6:, l7 OTHER OSI�b �.AccessoryBuilding
(SPectfy) ��� 7. SwimmingPool
B: SEWE S �99j8. ❑ Gazage Detached Attached
l. �Public (Name of System '�eM��/1 G. Lot Split YES NO �
2. ❑ Pri'vate(Septic Tank,etc.) H. Flood Zones YES NO _
C. WATE�: I. Sump Pump YES � NO _
1. �l PubGc (Natne of System G�Q�1 J. Manufactured Trussea YES _ NO ✓
3, ❑ Private(Well ) M
D. ZONING: �—� K. Plumbing Contrector /,�A,O� �7�
E. 'ESTIMATED CO$T OF CONSTRUCTION —!
(Excluding Land Value) �DO��D.• � Plumbing Licenae# �100 Zq��30CA or O CABO
�wrtrwssrtssrsesx+rt�tstitttrfstsss�aaati'i�itrt**st�rws*s�rww►srsss��rssisrsitra+tr�*wW�kxl►saaasttrrs4s4s►►ss►s
T'he undersigned agrees that any consiruction,reconstruction,enlazgement,relocation,or alteration of structure,or any change in the use of leud
or�VUCtwe.g requested by ttvs applicauon w•ill comply with,and conform to,all applicable laws of the State of Indiana,and the"Zoning Ordinsnce
of Cazmel�Indiaz�a-1993"(Z-289)and`am.endments,adopted'.under authonty of I.C�-3,6-7,�et seq,General Assembly'of ihe State of Indiana,and�all
Ac[s amenda[ory thereto. I fwther certiiy[hat only l:itchen„bath,laundry,and floo�:draim aze co�n cted to the sanitary sewer. I fur[her certdy
t6at the rnnsiructlon,will not�be�uaed or ocwpied untll e�Ce ' ate ojOc'cupqn�,tie,a�vgr��b�e�enrissu�d`by�therDe ar[ment of Community
S icea cI,InAiaua ,�j� ��/'""�'?��. •.�� ' • `jiQ�
F ` �6�Ins ��e���ar��'�G'Pf
' �� � �pt e/t.t
�� F�� d�r'sl�I�� Met�'8�se
ature o `rer o ut}lorized Agent �4 � T
I/� �9 � .��, � cio
�(Lk., �-t� N�Z7 3�7 82(,-q13$ 9j '� � 57 •" --��..�
(Print) (P one Number) e�mit,(S � e Footage)� � " ' ... �_�
-- O�J
Sewer Capacity Allotted ���� � • � ? ion Fees: �
Plan Commis nB'LA Docliet#: Certificate of Occupancy: ���
O'�
TOTAL:
vie A roved; Dept.of Community Services Fce Received B .: �a� m��