HomeMy WebLinkAbout0148.97 Application _
t �'�`Clay Permit No, ;(���
ss;�n;p� Application for Dac�_�������,r„
� Roll Fil
Improvement Location Permit
Ttiis�.peanit'is valid only;if consVUCtion is started within 120 days of lssuence date;all consVUCtion must be completed(c/o issued)within 2 years of issuance,
date'unlessade�ctension�oftimehas6een�o�ciall `rantdA�b� IettBrti���the�Diiector,De rtmentofCommuni SerJices.
NAME PNONE FAX
BIJII:DER �:�:ck o:r �; CoNS r4��•o:� ��; 3� � -- 853 �`�8- �353
SfItEEI' CffY SfA'IE ].IP
e . 0 . ,; \ 0by e. urm Z.� `rbo33-
TENANT NAME
_(ifa lic$ble
NnME PHONE FA%
OVVNER ��
S[RgET Cii'y STATE LP
LOT SLIBDMSION � S2CIION
LOCATION \ c'a��..5 ' '� `i ,a r1 G��
ADORESS OF'CONSfRU � N� /
' /.
A. TYPE OF CONSTRUCTION Do plans'includea p ich? F. TI'�E,OF IMPROYEMEN'P
l. ;� Single Fataily 0 Yes❑ l. ,�S New SVUCture
2. ❑ Two Family 2. ❑ .Addiuon Porch_Room_
3. ❑ Multi-Family Type of I'ouncti.ti �� ❑ Itemodel' � Commercial Tenant Space
4. ❑ Commercial/Industrial �Gra�vlsqacr. � oundation Only
5: ❑ Earm �Bssement ` ��, olitiop
6. O, OTHER ❑Slab ` '�� �r 6 ❑�:ccessory Building
�SP��Y) ��j ❑' Swimming Pool
B. SEWER: 8. ❑ Gazage Detached Attached
1: � Public (Name of System C 4 r rn�� ����•�`z S G. Lot-Split YES _ NO l
2. ❑ Private(Septic Tenk;etc:) H. Flood Zones YES;_ NO �
C. WATER: I. Sump Pump. YES � NO _
1. �S[ Eublic ,(NarneofSystem c-af:tr2�) J. MauufacturedTrusses YES _ NO �
2. ❑ Private(Well' 1
D: ZONIlVGl S — � K. Plumbing!Gontractor QO.v�� F S M•� r?`�.
E, ESTIhIATED COST OF' ONSTRUCTION
(Excludutg"'Lend Ua1ue) '� 2\C p�iJ Plum6ing License#.. ������� ❑BOCA or�CABO
t1�.tttY�,w###4t+kkt±F##ittF**tttrttY�l�.Mrtti�.W*!Y###tt##k/i##►##t##�►i#!#3t#i�tl�ii3iitttf tt/itt#i#M#ttMY}+1*t►4i4R►ktRtk
The undersigned a�ees that eny construction„reconstruction,enlargement,relocation,or.alteration of siructure,or any change in the use of lend
or shucmres reques[ed by thisapplication will'comply-with;and conform to,all applicable laws of the State of Indiac�a,and the"Zoning Ordinence
.of Eazmel�Indisna�.-�1993"(Z-289)and�amendmenLS;adopted.under authoriry of I C�36'=7�et�.seq;General Asserubly�of the State of Indiana,and ali
Acts��amendatory�thereto. I�fiirther certify that only�kitchen,bath,.laundry,audFflbo,drain�a�re�connected'�to the sanitary sewer. I further cer[ify
, ✓ct'P e_� "`i p`/:i'.
tLat t6e rnnatructlon,vrill nottie'usedtococcupied until a Cerd'fuate oJO� pancyhas beeo��ssued'6y,�`theDepartment,of 6ommuoity
Services, Carmel,InBiana �Q�'�Ql�;,�,''�!l4�Cv�I�,'F'��//�
Tnspecti n�,L�I.
dy��9 ��•� � a h .; - 6�'(Dn �, , ' f
no„� � ersab �B,�ou�h�Inr'Q�M'ete�cB��,,;
Signature of Owner or Autlionzed Agen4 � �'ss
��<:k�.�.�� c.n,N51:f..t'��.o:�7�• , 1��� ��� � �io�% ��
-c ti��-e5e � .��kti0.� . ��B-�8 � r��r _; �;��
(Piiiit)� (Pfione Numbet) _ ' � ,
Sewer CapaciTy Allotted . � F�. ection Fees: ��
°Ian:Commissio Docket#:'. _�� ��?.Ce a f OccupBncy: ��
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T�T : ��
R' '_, ed/ ppioved. D"ept ofCommunity'Services F R ived y a.��� ���
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