HomeMy WebLinkAbout0141.97 Application Carmel'Clay Permit No //% �� ;
' ��o:.��: Application for na��L �7 � '
'Im rov ment Location°Per�nit �R°°F����
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This permit-�is'�velid�only�if consWction is�sfarted w�Uiin�120 deys of issuance date;all coristruction musf be completed(c/o issued)witltin 2 years,of issuance,
�date�.unlessaneMension�.oftime`hasbeenofficiall ,�ran[ed�b �lettetb theDirector,De artrnentofCommuni Services. �
NAME PNONE - FAX
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SIREEI" CT' SfATE� '.ZIP
.� 7 W ` M n `S cc i'n�° 'N ¢ 6
TENANT IYAME
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tlAME� /,� "PHONE` FA%
OWNER `�Y � C
$TREET CffY SfATE ZIP
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' � LOT AINDIVISION� 52Ct10N
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ADDRFSS'�OF-CONSIAUCf10N
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A. TYPE'OF CONSTRUCTION Do pl include aporcli'--? F. T1'PE OF IlVIPBOVEMENT
1. [� Single Faauly �Yes O No, 1, L� New Stiuoture
2. ❑ Two Family �� 2. ❑ Addiuon Poich_Room_
3. ❑ iviplU-Family Type of Feundauon: �. . ❑ Remodel ❑ Commercial Tenant Space
4: O Commeroial/Ind'usu`ial ❑Crawlspaue Foundation Only
5, ❑ Fai=m �Basemeni � � ` emolition
6. ❑ -0THER ❑Slab �� 6. soryBuilding
(3Pecify) �'�j� ❑ g Pool
B: SEWER: '�/jf❑ Garage Detached Attached
1'. �[ 'Bublic'(Name o85ystem � �t�l> � G. Lot Split YES _ NO x
, 2, O Private(Septic Tank,etc.)� Flood Zones YES NO �
C. \VATER: � �� ump Pump, YES �_ NO
1. �� PubLc (Nazne�of.System� ��� . �L S' '� � J. � ufacturedTrusaes YES �_ NO
2. ❑ Private(Well 1 �6'
D. ZONING; S— I �9 PI g,Contractor �� �DO�!�
E. ESTIMATED,COST'OF CONSTR TION , �f3�pd��p S
(Exclading Land Value),�� d a
Plu ing License# ❑BOCA or�CABO
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The undersigneci agrees that eny construction,reconstruction,enl:irgement„ ocation,oralteration of struchire;or any change in the usebf land
or shvcMes requested by tliis applicalion will comply with,and:conform to;all applicable laws"of the State of Indiana,and the"Zoning O�dinance
, . .� ,
of Catmel Indiana�-�1993"�(�289)end amendmenJs;ado , er au_ only-s � .C.36-7 et�seq,.General Assembly�of the Slate of Indiena,and all
�Acts ameniiatory�[hereto I�futther�certify..tktat only �. hen,bath��,:laundiy,and�flcw . �ain�ue c:onneated to the sanrtary.sewer. I furtheccertity
[hat the rnnstruction will not be�used or oc pied u�C" ftcate o Oc upa; has been is`sued by the Department of Community
Services, Carmel Indiana:
� :'/�/ � spections Needed:
j�� /J7 i.�
� � . � , �. .' � � '��.. ,'.�Fob ' � a Rough- � MeterB� e
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Signature of Owner or Aut}iorize3 Agent _
Site Fio
�/l�'('f�l��' �OM1f�n �Z- 2��G� x�¢Gf 3
�(Piint) .. .hon umber) Peimit(Square Footage) � �
>�j' �j nc�tNbEU rUt� ;,v�d.`;7F?�i,T10N '�., �j ����
SeweiCapacityAll'otted / ( / '� �»IPC! ,f0 COi�p�SOVlL�;v�•6ionFees:?���d�Rttr ��
� �rfl1P�(�!t'!'2d O'7/I. �.nrrP 4'.,,s�. / �
Plan ommission/ ocket#> �' Certrficate of Occupancy: G �
— COfv�lrSi1N�TY L�EVE PME(�'-
CITY OF T^� D1 ' J ///7
' ' ' r, a 1 f . �.: � r �/ �/I/ l
Revie � of Comiaunity Servioes Fee eceived By .:��w m!�
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