HomeMy WebLinkAbout0128.97 Application . j��� ann Clay - ' P rmit No`, �� c
Application for �8c� 2. �
�:. � ��
Improvement Location Permit � Roll Fil
Ttiis.permiE is,valid only.if wnstruction is started within 120.days of issuance date;alFconsGuction�must be completed(c/o issued)within 2 years of issuance,
date'unless��an�eztensionoftime�.fias��.beedollioiall tuntedti Ictterb�theDirector;De entbfCommuni Services.
. - N "�e- � vxoNe �yy� en�c
BUII:DER' I � ' • C�/IYL C� T�O�O� `
� � rrc /n � srn�z �r �.`�.5 fo
��
TENetiNT=NAME
ii'�s licable
NAME �PHONE� FAX
OWNER ��n�
Sf0.EEf � CfiY SfA'IE lJP
LOT ; � SUBUMSI ��✓!' L-C.OI . }y�//` SECIION
LOCATION � `
� . . ADDRESS OF COa�,o��s
A. TYPE':OF CONSTRUC �",�,Lj.o plans`'inclade a poich? F. 1'PPE F IlKPROVEMENT
1. �Single Family "� �„F��'"� es O No 1 �Neiv StrucRSe
2. Two Family � � 2. ❑ Addition Porcfi_Room_
3. ❑ MuIU-Family �}"'e Type o, on: 3. ❑ Remodel ❑ Commercial Tenant Space
4. ❑ Commerciel�/Industn'aha �,¢ Crawl'space 4. ❑ Foundation Only
5, ❑ Farm �asement 5. ❑ Demolition
6. ❑ OTHER �Slati 6. ❑ Accessory Huilding �
�SPecSY) 7. ❑ SwiinmiSSg Paol
B, SEWER: �/'/ 8 ❑' :Gazage DBtached Attached
1. Putilic (Nazne of Sys[em �( /`�!!� � G. Lot Split YES _ NO �
2. �Private(Sepuc Tank,etc:) H. Flood Zones YES NO
C. WATER: ��`6y�. Sump Pump. YES _ NO �
1. `� Public (Name of Syst s�. anutactured'T'usaes' YES � NO _
2. ❑ Priva[e( ell 7 � �
D: ZONING: — �9i}K mbing Contractor .��J51 �
##ii#i+it#*#*#*rt/t?k_*tttt#+kMi►*itik#t#ik##ti#t�++Ft?kY�.*# i�•.�iatssrs**sxsst�s.l�O ��OCA�or�OCABO
E. ESTIMATED'COST OF�CONSTR C ION
(Excluding Land Value) Plumbing Ircense#
. . . � . . st#ssss?Y��ttt4iti/#t4tKiii
The undersigned agrees that any.construction,reoonstruction,.enlaigement,reloca[iou,oi alteration of structure,or any change in the use of land
or structures requestie�by this applicationwill comply with,and oonform to,all applicable laws of the State'of Indiana,and the"Zouing Ordinance
�ofCazmellndiazia-]993"(Z-289)and���amendments;,adopted�under,au[hontyofI.C..36-7 etseq,-General��AssemblybftheSlateoflndiana;andall
-Acts���amendatory ihereto. I�furiher certify that�.only:kitchen,.ti , oor drain>aze connec[ed to the sanitary sewer. I further certity
f6at the construction will'not 6e used or occupi til.a CerliJj,c�c cy has bcen issued by the Department of Community
Service ,Carmel,Ind'a a /
I/
_ `�� '�O���u spections Needed:
� �. .��L Foot g/U ers - �M er.�
. ignature of Owner , u onzed;Agent
-l�e�a, a '�� - '��-��a7 e F
`(Print)' (Pho e Num6er) Pe Square Fuofage) l
, ���
Sewer Capacity Allotted _ _ � Inspection Fees: '
Plani.Commissi p/F3ZA'Doo et,#: Certificate of,Oceupancy: ! �
TOTAL: �� �
�° �% � ��(����.
R " Ap`r'q,: Communiry:Services FeeReceivedBy •:��em ���