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HomeMy WebLinkAbout0136.97 Application (2) Caimel,yGay Permit No. �To.�i,;p, / Application for � Da�_����� �� Improvement Location Perrrcit R°'1 F'' 'This.permit is valid only if constructiomis started wi[hin 120 days of issnence date;'all construction-musf be completed(c/o issued)within 2 yeers of issuance, . date.unless�anextension�oftime�hasbeenolliciall � ranted��b lettenb theDirw[or,De artmentofCommuni Services. , N E PHONE" FAX BU�ER l�'r�w1 ���,�� z��- � z�z �s� � z9.z ,SfREPf' CITY SfA'IE TIP � a rEJI1l �l �� �'� �n� "�. TEIYANT 1VAME (iEa licable � N E ., PNONE ,- FAX owivEx v9it �U���J1n ?,l-!�0�11 STREEf -CITY SfA'IE ZIP LOT SUBDMSION SECIION ioenTioN �b �'r'`S M �: � � �Z-- � ADDRfSS-��OF�CONSIAULTION .� � �{= t1w� � G,�- `� ,: -� A. TYPEf�F CONSTRUCTION Do,plans inclu3'e s p' 1'YP�E Il17PROVELYIENT l. g Single'Family ❑ YesLL� ��� y� New Structure 2. ❑ Two Femily " � Addiuon Porch_Room_ 3 � Mulu Femily T e f Fo ddau6 _ Remodel ❑ Commercial Tenant Space 4. ❑ Commercial/Indastnal rawlspace % 4. � undaGOn Qnly 5: ❑ Fum ' eineri ,,� 5 emol�Lon ., 6. ❑ OTHER Slati ',�+6. ❑ Accessory Building �SP��Y) 7. ❑ Swimming Pool B. SEWE : S. ❑ Garage. Detached Attached� 1. �Public (Name'of System�7��� G. Lot_Split YES _ NO 2, O Private.(Septic Tank,etc.) H. Flood Zones YES NO � C. WAT �' I. 5umpPump YES.� NO 1. �Public (Name of System � �g- � J. Manufactured Trusses YES NO � 2. ❑ Private(Well ) � " • D. ZONING: � K. PlumbingCootractor 1I�Si4''� Ei. ESTIlYIATED COST OF COPT TRUGTION (Excluding Land Va16e) ��F L'c�v:� ``B Plumbing Liceose# - o�+l OCA r❑CABO' �tt*r�s*.**r*wss+ra+swrtsss►ars*ttsi*x[s#ssskr�tt*rtr�t*•e**sk*a*tt*sttt*s+sst*taa*+s�frr sisssssstrr Ttie undersigned agrees,that any construction,reconstruction,enlargement,relocation,or alteration of sWcture,or any change in fhe use of 1and or:shuctwes requested 6y this application wi11 comply with,and ccmform to,all applicable{aws of the State of Indiana,and the"Z.oning Ofdinauoe ofCarmellndiana- 1993"(Z289)�andlamendments;adopted�under.authority�ofI.C.�36-7 etseq,GeneralAssembly'ofthe.StateoEIndiana,and�all Acts�.arnendatorythereto. I���.furthercer[ifythatonly��ki[chen;:baUi;laundry;�snd�floordrain,aze�connected�tothesanitary.sewer. 1 furthereertity thaf the construMion will not.be�used'or cecupiedlunf0 a Certifrcate ojOccupancy'has beeo issued,by t6e DepartmeofotCotnmunity Services, Carmel,Indiaua In� ections Needed: � .. J(�+ ��� �� �c�� .. t!� _ . . ..- —[� r � ;w `� ndersla� .-Rough-In. eter:Bas Signahue of Owner.or Authorized Agent �5��. J���e�i , t✓ °'` � t � i.r , VY��'���l.� ���-7 �- M ,� (���l� �te;�� � ,.._ C � T (Print) (Pho Number) ��`���,��,41'i`�t�(S�uar��E^e[age) SS3 � ty, u � SewerCapacity�Allotted. � ' y;G�ti Q!` ��r��,�,4'��'°��uo�n.�F'e�rs'�,.G�. .r G� - . c p.i .rl' ,�'��•,�i•pT , rJ""� � �+ l3' P1an Commission/BZA pocket#:;. _ r�G\\C�efu'fiiate.of Occupancy: ��� � � � {,�tTOTAL: � ,�. evi � Community Services Fee Receiv y .:�+�s em m�� �