HomeMy WebLinkAbout06010028-ApplicationCity of Carmel/Clay Township Permit #:~~'
COMMERCIAL or INSTI.,.T~,TIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional. New Structures, Additions, Remodels, Tenant Finishes, &Accessory Buildings
BUILDER of
RECORD:
PHONE FAX
~o0~ V ~T~
STATE COMMERCIAl, SCOPE(S) OF
SEWER UTILI'Pf
PROVIDER: J PROVIDER:
~CKE'T NUMBERS; AND/OR
SEPTIC PEP, NIT #'S (If Applicable);
C3 SPKLR
ZONING:
ESTIMATED COST OF CONSTRUC~'~ON:
P O-E ~ - - :N:
Does any part of the property lie within a special Flood
dseignafion aroa: Y_~N
. IMBIN ~ ' OR-'
Plumber's Indiana State License #:
to the Ge~ana (See 675 IAC 12) r~ga~i~g expiration tirae frames for
beginning and completing cons~cuctio~
2.89) and an~.endr~e~n~a~o .p~ed uader authority o£ LC. ~6~7 et seq, General Assembly o£ the State o£ IncI~ana, mad allActa araendatoxy thereto. I further cerc~y th~t only
kitchen, bat~, ~d~r d~ains are con~aec~ed Co the sam~azy sewer. I further certify that the consn'uction will not be used or occupied until a Cern'cate o£
t~oa bas been issued by the Deparunent of Conununity Services, Cannel, Indiana.
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