HomeMy WebLinkAbout14060021 Application CITY OF CARMEL / CLAY TOWNSHIP 1'ERMIT # ,�y06o0Z�
COMMERCIAL/INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
� �xo� For New Structures,Additions,Tenant Finishes,Remodcls,and Accessorv Struclures
BUILDER I NAME . PHONE FAX
�F ( erso� C efc,w� G�ow 7- - �'DU 3 i)- �' �- 3�'O/
RECORD sraee aooaessI cm SfA7E `/ uv /
IS3v ltnef�G�n U)a, sw e a� Greenw�o �✓�/ �D���J
E-MAIL ADDRE55 1p BEST METHOD OF
WS G�(j PYSO� CQ�MQ�C�L. i�pM CONTACT �M�.
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F�LUMBING NAME STATE OF INDIANA //� �
(:ONTRACTOR � LICENSE NUMBER l� /
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PROPERTY NAME PHONE FAX -J
OWNER SLVC G /lCf S ' .3 3S'��jII JI7' S�S -o�S��O
STREET ADDRESS CITY � STATE � ZIP�� ��
303 bn e ���nw � �,-
PRO]ECT PRO]ECT OR TENANT COMPLEX AN IL N NUMBER OF FLOORS ELEVATOR
LOCATION Se✓�+ CorneJ 5 ❑ ves � No
SfREET ADORE55,INCLUDING SUITE�MOB`ER ��f� STATE �� ZIP� D�
�� Con resso��- � ✓ � �
HAMI/LTON COUN ARCELNUMBER ZONING FLOODZONE/5
ry -�1 �` I �f '07 -60 - 0
lOTSCLIT SEWERUTI�7Y WATERUT SEWER/WATER
❑ YES O NO J�� UTILiTIES El(CAVATOR
TYPE OF ,T�Y/PE OF CONSTRUCTION Number of Unitr
PERMIT ��-OMMERCIAL 0 MSTITU ONAL-❑MUnicipal/Public Building �School ❑Church ❑ MULTI-FAMILY
EARLV RELEASE TYPE OFIMPROVEMENT (�
❑ vE5 ❑ NO � NEW STRUCTURE S�r `�1��'��y�}'�q7TqCHED GARAGE ❑ACCESSORY BUILDNG ❑ CELL 70WER
❑ADDITION-❑ROOm/s❑POrch L�17����@� ��� DETACHED GARA6E ❑DEMOLtTION ❑ CO-LOCATE
PRO]ECT P�N COMMISSION/BZA ��AN ESTIMATED COST SQUARE POOTAGE
TAC DATE/5 ��� COMMUNITy S O�C UD NG U1NDN 7 UO �- � � � W�'�
PDi PLANS TYPE OF FOUNDATION ��a'� AV TOWNS �"SSES URED MP PUMP PORCH
[] CC� ❑ E-MAIL � SLAB ❑ BASEMENT-❑W.�� d
❑ CRAWLSPACE ❑ POST&BEAM PIER ❑ YES dN0 ❑ YES L�YNO ❑ YES NO
STATE OF �DR NUMBER RELEASE DATE CONSTRURION TYVE OCCUPANCY CLA55
INDIANA V
CDR SCOPE Oi RELEASE ❑ HOOD TYPE OF RELEASE
❑ FDN� STR� ARCH❑ ELEC❑ MECH❑ PWM O SPKLR ❑ OTHER
Class [structure Nermits are subjeci to the State of Indiana Genexal Adminisiratice Rules(CAR 675 IAC 12) regarding
ca��i�ation time frames for be�+innin�.and comvletin�construction.
I.IIi¢undersi�.ned,a�rec that an�annstrucNon,mmnetrnclioq enlar�ement,rdoia[im�.ural[eration ofa s[ru<'t�ve,or an�ohan�.<�in the use ofland or
a�rurture.reyue�LLVl b�'thix application.��ill cumply wi�h and c-onlorm to all applirablr laws ufthe5tate uf Indiana and thv"(onin�.prdinanreul Carmrl
India —1993"(7-28Y)and a �Jm ts,aJupinl underauthority ol'LC 36-7 et sey.Grnrral Assembl��uf tlie S[a[e nf Indiana,anJ all Actsamrndaturc
�hrrrta 1' rlhercer[i(v[hl nh-k` �hrn.bath.andlloordrainsareconneiYni[uthesanitarrx ver. Ifurthereer[il\'tha[fhecons�ruotiun�villnutbr
� �r oi' upivd until a C ficale .f Ucn�panar or niSuFslanlial Cumpletion has br<•n issu b�I`Ihe Ucparlmeul ofCummunih�Serviceti.Carmel.Indian.i.
` SesS �o�pefSO✓� /
Sign e of Owner or puthorii tl Agent Printetl Name Dat�
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............................................. .............. ..,
REQLIIRED BASE INSPECTIONS * '• '• pERMIT FEES
* Additiunal ins �ons may bcl�yuired. : Filin� / Reaic�+� Z�•7o Re-Review
No vw7.� : s,sti„s�>«c���,. 1�9.00
i ❑ I,o�ccr Foutin� Rou � Pire
: Cert. ofOccupanc:c 2 •00 Olher
: ❑ Upper Footing ❑ Mctcr Basc ❑ Forestry �.
� P.RJ.P.
� ❑ Underslab ,�Pinal ❑ Sitc
TOTAL 7 � 70
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