HomeMy WebLinkAbout0133.97 Application ��
��'� ay Pernut No.
'I�o.u�;s._ p
Application for � Dar� v. � 3 3-�..,
Improvemenl'Locatio� Permit RollF�l
Tfiis,persnit is valid only�if consWction is�sfnrted within 120 daysof issuance date;all consVUCtion must be wmpleted(c/o issued)within 2years of issuence,
'datebnlessenezterisiomoftime�has��been�otTiciall �°iaiited'.b letterti".ttieDirector,De aitmentofCommuni ,Services:
NAME� PHONE FAX
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. . . � . SfREE! CII'V STAIE ZIP
; �1 r �L
TENART NAME n ��� ��
, (ifa licable) �'C�e� �m
NAME PNONE FAX
��R " `� 191997
,
� siic�ei� cm �srw� ve
LOT SUBDMSION SECIION
IACATION ` S'}�hev-��Ll� a3
ADDRESS OF�CONSIiIUCIION�
II ?.� P�bbl� �;,�-�. IPn � Ca� � �/�07�
A. 1']�E OF CONSTRUCTION Do plans j�icluc3e a porch? F. Tl?�OF Il�IPROVEMENT
1. �8f Single Family �I�Yes�No l. New Structtire
2. ❑. Two Family 2. ❑ Addition Porch_Room_
3. ❑ Mu1ti-Family Type o .oundatiun: 3. ❑ Remodel ❑ Commercial Tenant Space
A. ❑ Commercial/.Industrial' �Ispxce 4. ❑ Foundation Only
5. ❑ Farm asement ,� �.�,m� ❑ Demolition
6: ❑ OTHER ❑Slab „� ����� ❑ Accessory Building
(Specify) ��+� 7 ❑ S�v�ciuning Pool
B. 5EW : ^" '" 8 ❑ Gazage Detached Attached�/
1. Public.(Name of System„ . - � , Lot SpGt YES _ NO l�
2. Private(Septic,Tanic;ete.) H. Flood Zones YES �NO �
G. 'WATER: F Sump Puump YES NO �
l. �Public (Name of Sys[em. Fe �s anufacturedTruases YES _ NO
2. �❑ Private(We� • /
D: ZONING: � �, �`99�K - umbing>Contractor �/�✓�e�°� , , i V✓l_
E: -ESTIMATED COST"O�Fg���ONS;�RUGT N y' �
(Excluding�LandValue)"IO2��%i��� � � plumbing��License# �,`� �30 . �-BOCAor.❑CABO �
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The nndersigned agrees that any constnichon,reconsuuction,8nlargement;relocation,or;:alteration of sWCture;or any change in the usebf land
or stiucduts reqi�ested by tkvs'appl�cation will comply„with,and confotm to,all applicable:laws of the State of Indiana,and the"Zoning Otdinance
� bf Carznel Indians- 1993-',(Z=289)and amendments;,adopted'undeY authoriry of LC.:36-7 ,et seq,General Assembly of the State of Indiana;snd all
Acts aineniiatory the�eto. I fwttier oettify tha[o kitcfien,bath,lauadry,and flooi.diailu are connected to the savitery,sewe[. I fur[her.certity
(t6at��t6e�coustroction�will,not;be uacd:oc � upied'untd.a Certiftcate.ojOccupancy has been�issued�,by the DepBrtment�of Commuuity '
'Ser,vices, e � el,Indiana.
1 � I ecfions Needed:
.Foot' n rsl- - .
Si "a4are:of O or,A orized g t
L [.� �O�t- � ljL�(,�IC.0 3 Site /O
C
.��,C/✓lF_
(Print) (Phone Numberj Permif(Square Footage) ��
Sewer Capacity;Allotted' p� ` �� Inspection Fees: ��l��
Pla�rCommission)BZA Docket#: Certificate of Occupancy: �J
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R ' ed: De t:o ommucuty Services Fee Received By .:��sb m��
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