HomeMy WebLinkAbout0129.97 Application Caimel-�lay Permit No. f��'�i
��:�i;p Application for Dace�i"' �
`' Iinprove�nent Location Per�mit �R°v F''
This,pertniUisvalid.only:if wnstruclion�is�started.withiin.120 days of issuance Aate;�all consWction must be completed(c/o issued)within2 yeats of issuance,
,date�;unless en eztensiom$f time 6as�been officiall�' ianted�b letter b tlie Duector,De ar[ment of Communi Services.
�. .. .. . AME �./ PMO '�/ FAX
B[JILDER 'W /-��/' �7.J'S"�G��
... . .. . srxe � � cm � l . [ '�'� �
/ -TY� s
'iENANT NAME
(ife ��7icablc
NAM PHONE FAX
O'WNER � "��
. . _ STREEI' CIIY SfATE LP
LQt SU9D ION. �^ / SECIION
LOCATION _ , V / v
ADDRCSS�OFCONSfAII � ��'
C7� � �
A. 1'YPE OF CONS �� clude a porch? F. 1'PPE OF II�IPROVEMENT
I. [�Single Family � - s❑No 1. �'New.SVUCture
2. �7 Two Family 2. ❑ Addition Porch_Room_
3. '❑ .Multi-Faznily �� ' 4 T ebfFoundation: 3. ❑ Remodel ❑ GommereialTenantSpace
4. 0 Commercial/Industrial ��OCrawlspace 4. ❑ Fouudalion Only
5. O Farm ❑Baseme�t 5. ❑ Deinolition
6. C) OTHFR �Slab � 6. ❑ Accessory Building
(SPecifY) 7. ❑ Swimming Pool
B. SEWER: � 8 ❑ Garage Detached Anached
l. Pubhc (Name of System F Lot Split YES _ NO �
2. � Piivate(SOptio Tank,etc.), �.;' , Flaod Zones YES NO
C: WATER: / J L �mp Pump YES _ NO �
1�. '� ..Pu6lic (Name of`Systenli��� 9��.�nufaMured Trusaes YES l NO ,
2. .❑ .Private{ ell �
D. ZONING — K. Plum6iag Coutractor � ��
E ESTIMATED COST OF CONSTRUC�T�O�
{Excludmg Land Value) j��� Lx�`-' \ Plumbing L�cense"# /���/'�^R'OCA or 0 CABO
t*s#+ketit#if►###t+ktV�**rti#Vti!k### ##aW��#tl+i##tiittkt####tt#i*tYY*aia#s##*►st*+tt+Ftt►ttrti/f►�###iit/�k
Tfie u¢dersigned agrees tliat any consVaction„reconstruction,enlargement,relceatioq oralteration of strucmre,or any change idthe use ofland
or sWetuwes requestcd Uy.tttis application will'comply wi[h;.and conform to,all applicable laws of the State of Indiana,and the"Zonittg Ordinence
ofCi�smellntliaz�a-1993"-(Z-289)��andamendments,.ndopted��underau[hority�ofI.C'.,36-7 e[�seq,.GeneralAs.sembly'oftheStateoflndiana,andall
Acts,amendetory�.thereto. �I'furthercer[ify.that-only.kitche ,-dTt�clfy,-en oordrairuareconnected��to�theseniterysewer. Ifurthercertdy
thacittie�rnastruMion wiR not be used or occu " until�a�/�c7erlificate ofJ/�7��j.c ncy 6us 6een issued by.�the Department-of�Community
Se[vices, Carmel;Indiana ��//�[///�/ln,f ii„:�U/j i 5
��/""-_ �uiriv� I ��
� q —T��� , y � ections ed:
,� � � �/1 � �� �P ' °
l���JV' � - A� � F t.in ra d gh-In eter Base
Signeture of Owner uthorize Agent
� ��' , � �//���� ite Final C
`(
(Print) (Ph e�Numtier) Permit(Square Footage)
SewerCapacity;Allot[ed_ � � 'Z� .�. InspectionFees: ��J
c�
Plan Commission/BZA T�ocket#: Certifioate of Occupsncy: /`�'
TO AL:
� ; ,
/ //� i, �� ��,
�LU/�X 'A / �
R'ev�e t:of Commuuity Sernces ee Rece�v By �:v«wum�em m��