HomeMy WebLinkAbout0004.98 Application�aimel-Clay
�Town;p Application, for
Improvement Location Permit
This: permit is valid only if constructionis sta_rted.within 120 days of issuance date; all construction must be win
date unless sn'extension of time has been'ofiicialiv granted by letter bathe D reIetor, Department of Community
Permit No.
Date 2 O 7 O
Roll File o
issued) within 2 years of issuance,'`
NnNE
NE
PHO/7
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STATE VP
S, ,Z_✓,
TENANT NAME
if at2licable
NAME
PHONE
FAX
OWNER,
n
r/
STREET
CITY
STATE 21P
LOCATION
LOT.
WBDW 51ON
S f) A) F /li MS
SECTION
ADDRESS OF CONMUCDON
Al
A. 'TYPROF CONSTRUCTION
1.
P Single Family _
2.
❑ Two Family
3:
❑ MultiFamily
4.
❑ Commercial ',/'Industrial
5.
❑ Farm
6.
❑ OTHER
B. SEWER:
1. & Public (Name of System C
2. ❑ Private (Septic Tank, etc.)
C. WATER:
2.
of System
OF
Do plans include'a porch'?
Yes KNo
Type of Faandstion;
❑Crawlspace
OBasement
❑Slab
F. TYPE;OFIMPROVEMENT
1. R- New Structure
2_ ❑ Addition Porch _ Room
3. O Remodel ❑ Commercial'Tenant Space,--
4. p Foundation Only i�`�? � iz F.4 V L f $l
5. ❑ Demolition.
& ❑ Accessory;Bwlding
7. ❑ Swimming Pool
8. ❑ Garage Detached —
Lot Split
Flood Zones
Sump Pump
Manufactured Trusses
DEC 2
Attached
YES_ NO
YES NO;
YES NO
K. Plutgtiingi ontractor kL MooRrz
161
The undersigned agrees that any construction, reconstruction, enlargement, relocation,, or alteration:of structure, or any,cbange in the use of land
or structures requested by this application,wi11 comply with; and conform to, all applicableSaws ofthe State of Indiana,, and the "Zoning Ordinance
of Cannel Indiana- 1993"(Z-289) and amendments; adopted 'underautliorityofI.C. 35-7, et.seq, General Assembly'ofthe State ofIndiana, and. all
Acts amendatory thereto I further certify that onlyl_itchen bath, laundry; and floor,draihs re corm ` er. I fdrther certify -
that theStonstr u tion will notbe used or occupied until a CetW tca/eARE"—mtiJo�en- deb ent of Community
Services; Carmel;Indiana (;ALL PO=R��i' g�yy Ct7�1t �IQnce w lI-all U1afton.t
✓- R�1T__L/-1
DP 94�
_ FOR F
Sighatute of Oiv ner or Authorzr<3 Agmt
r;`C I� Cn) Ii t,1, S M l j1}. SS`6-fs7
(Phone Ntim6,2-1'))
'0
Sewcr Capacity Allotted A!_I
OF
Permit (Square Footage)
Inspection Fees:
Certificate of Occupancy:
TOTAL:
:r Base
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