HomeMy WebLinkAbout0157.97 Application ��C �Glay Permit No�./ �/ � ,�-rj�
p Application for � Da�_i�%/ i ,�
''�M I m p r o v e ri i e n t L o c a t i o n P e r m i t R°"F''e.' � T
Tfiis'.permd is�.valid'only�ifconstruction��is started�wi[hin 120�days of issuance date;.elPconsWCtion must Se completed(c/o issued)withim.2 yearsnfissuence,
da'te�unlessan�extension of:time��has�been�ofiicial( � ran[ed'b` 1etter b-.the Direc[ot,De artment"ofCommuni Services.
�,unme' L� PHONE � FAX
BUILDER L�. ��SI� G'`- � � � �
� SIREEI' �i- / �� // (,'j. /'� �-�_Cf1Y. / - �� � �� � SfATE ZIP� � . .
5 � , C'J, �
�, ,. c�
�
TENelNT NANiE
� . if u�-IicAblc) . /
����/•� � � �PHONE /7 ` // ' � O,./�0 FA%
OW!VER
a� �;-v �
�� sl�1��►� 1. �'`�J? . � �;' I �G'! �A �d, y" q-G o,3 `� �
�ar . sue�rns�ox . /' /r - secn x �j�
LOCATION � C� M�!' �D�L� . L� �
ADORPSS OF�CONSIAUCIIO ��� � I . / � V\ C' l `��/ � ��
Li
A. 1'YPE OF GONSTRUCTION Do plazu include a porch? F. 'PYPE OF IIIIPROVEMENT � � ' J
1, �(� Single Femily ❑ Yes❑No l. ❑ e •y � �"
2 ❑ Two Faznily 2 Addiuon orcfi_Roomr�J`/� JZ m
;3: ❑ Miiltr Facnily Type of Fo�ndau" ; ` �-&emtfde'1 ❑ 'Commercial Tenant Space �
4: ❑ CommerciaL/Industrial ❑Crswl"sp 4. ❑ FounGation Only G /:/w � �
5: ❑ Fazm ❑Baseil' � 5 ❑ DemoliUOn `�
6"" ❑ OTF�R;� � �j�lab. ��� ❑� Accessory Building
�SP��Y) �l `� � I,p r � wunming�Pool
B'. SEWER: /� q 8 azage Detached Attached
1. ❑ Public (Neme of System �'� � < �. t Sptit YES _NO _
2 ❑ Private{Septic fank,e[cJ H��ood Zones YES _ NO _
C: WATER: � I: Sump Pump YES _ NO _
l. ❑, P"utilic (Natne of System'�� ) J. ManutaMured Trusses YES NO _
;2. ❑ Pndate(Well � f �
D: ZONING -� � �9 P►umbin ContraMor �" v ^ � � '
A S
:E. ESTIMATEL C T OT NS RUCTION �. � G �
(ExclucLng Land Value) �� G U • 'I bing License.# ❑B02"A or O CABO
•s,"t.t�ssttssststa�*r*+r,!� *w*.t....-ts,tsifisar*rrwwa t#�*x�ar �e �sii�i+�+*srsttsrr*r***s�s�s�rsisrsssss►**tss
Ttie undersigned agrees thaC"any c�nstruchon,reconstruction;enl ement eloca `,or alleration of structure;or:.any change in the use of le�d
a.s7uctwes reqi�esled by tivs applicatidn will comply wi[h;and co to,all calile laws of the State of Indiana,and the"Zoning Oidinance
.of Caimel Indisna-�1993"(Z-289)and amesidment's;aclopted.under au ' I G 36-7 et se �;�General Assetnbl �of�the State of Indiana,and all
` -' � �"f-t a- qn,-._ y .
Aots amendetory tl�ereto: I fiiRher ceRify that only kitch:,n,bath;rlaun and floor drain�aze'connected�to.the seni[ary sewer. I further cer[ify
,,. . .. , . ._^ �.er5r..r ": ' iJ'^ F'�1 -
that the construMion will not be used'or.occuPied until a Certifuate ojOccupancy:has been:us�edby-the�Depa um�e�i,qt�lCommuni[y
Seryices, Carmel,Indiana '�l` P•Ba!?�',Q yy[th �lJ
n�/Cen✓ £'n..:... utl/ Re
( �, f ` C��uN�l(��°S/' �'car�d slatio�a,r
�St e of Ownei r fiut}ionzed� w"'_ ' oot � _na�±sl�b, 4g �"1 •�e �.
`4ge�'�t7��?�-� /�[��
S � _ r�l �� yzs:: 9��� s,te q�,P , .. � ��,
(P ` ) - ne Number) Pennit(SquazeFootage) °"tJ �_�_�.
Sewer Capacity,Allotted F/ Inspection Fees; ���r,
Plan'CommissionBZA �et#`._ Cectificate of Occupancy:� /_����
! � ?f O G�1
�' '- i
_ , v� i r�_
Re ' ppr "ved: ept.of Community Servioes ee Receive By .:��mu m��
�� �