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CITY OF CARMEL / CLAY TOWNSHIP PERMIT# 1703016Li
COMMERCIAL/INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For New Structures, Additions, Tenant Finishes, Remodels, and Accessory Structures
BUILDER
NAME PHONE FAX
OF
'�- ( -317 in- 4 AJ
RECORD
STREET ADDRESS / CITY STATE I ZIP
LI.CQ
E-MAIL ADDRESS
BEST METHOD OF���
Cr t
p CONTACT -15—
PLUMBING
NAMEr
STATE OF INDIAN
LICENSE NUMBER
CONTRACTOR
/ (^
PROPERTY
NAME PHONE
(� X
OWNER
- 3 ~' ,P- ,/ V
STREET ADDRESS CITY STATE ZIP
s t _n y a
PROJECT
PROJECT OR TENANT COMPLEX AN/OR BUILDING
NUMBER OF FLOORS
ELEVATOR
LOCATION
❑ YES ❑ NO
STREET -ADDRESS INCLUDING SUIT UMBER CITY STATE ZIP
726
HA ILTON COUNTY PARC NUMBER
ZONING
FLOOD ZONE/S
0
LOT SPLIT
WATER UTILITY
SEWER/WATERElYES
NO
El17��
UTILITIES EXCAVATOR
TYPE OF
TYPE OF CONSTRUCTION ^1yn NC RIIr Number of Units\
REI FAR
❑
M.
PERMIT
COMMERCIAL INST[TUTIO Mumapa / : c School ❑Church ❑ MULTI -FAMILY
r7 brc�3d19M�1
^4d�W+yJ
EARLY RELEASE
TYPE OF IMPROVEMENT -'!
❑ NEW STRUCTURE ❑ ATTACHED GARAGE ❑ ACCESSORY BUILDNG ❑ CELL TOWER
❑ YES ❑ NO
�ll�(
�FYAtrAVN-'PPINISH
❑• ADDITION —❑Room/s �K9L4�4p-'rlrr.�tI{"�liT�,�u(►tStYBUEfRY�,1FSit1p I .DETACHED GARAGE ❑DEMOLITION ❑ CO -LOCATE
PROJECT
PLAN COMMISSION / B ) ¢PWJQT/
�¢F{MATED COST
SQUARE FOOTAGE
1tltNlEV / ULN I I lJl
TAC-0ATE/S INDIAN Ill YIV
�
STRUCTION, ��
t
EXCLUDING LAND
EXCLU 6
PDF PLANS
TYPE OF FOUNDATION
MANUFACTURED
SUMP UMP
PORCH
❑ CD ❑ E-MAIL
❑ SLAB ❑ BASEMENT —❑WALK-OUT
❑ CRAWLSPACE ❑ POST & BEAM ❑ POST & PIER
TRUSSES
❑ YES W NO
❑ YES ONO
❑ YES ❑ NO
STATE OF
CDR NUMBER RELEASE DA E
CONSTRUCTION TYPE
OCCUPANCY Y4SS
INDIANA
-8
`n -
CDR
SCOPE OF RELEASE I I ❑ HOOD
TYPE OF RELEASE
❑ FDN ❑ STRYI ARCH)C ELEC ❑ MECH-❑ PLUM ❑ SPKLR ❑ OTHER
r^ A
Class 1 structure permits are subject to the State of Indiana General Administrative Rules (GAV6T l® AWj.,fa7djt1g
expiration time frames for beginning and completing construction. uu MAI( ,6,
[,the undersigned, agree that anv construction, reconstruction, enlargement, relocation, or al leration of a structure, nr a change in the use of land or
structures requested by this application will comply with am] conform to all applicable laws of the State of In diana and th "Zoning Ordinance of Carmel
Indiana— 1993" (Z-289) and amendments, adopted under authority of LC. 36-7 et ,eq, General Assembly of( he State of In
and all Acts ame=sdatgry,;_ �
thereto. I further certify that only kitchen,boh, and floor drains are connected to the sanitary sewer. I further cerlifv lh, he-c'rnstrurtiml-a'111TiSl->�
do�1r ncc/Sy�pleJ until a CJy./yButq/o Occupaner or Iol�'S„uJhsl�an/l'i�al Comp�lJetion has been issue by the Department off`Cun....un Services, Caro el, Inc iana.
Sign of
ed Ag /tJS�o.d / 7 Fa l 4,15 �P_ESi� d Int�J I Y` ��
Sign ur! of Owner or Authorized A nt '—� rint�Name Da
REQUIRED BASE INSPECTIONS *
* Additional inspections may he required.
❑
Lower Footing
Rough -In
Fire
❑
Upper Footing
Meter Base
❑ Forestry
❑
Underslain
;;;,❑______/
Final
El site
It
E PERMIT FEES
i Filing / Review
Base Inspections
Cert. of Occupancv
P.R.I. F.
8_ 7, 0
g_ob
Re -Review
-Q
Other
AL 4P/060-7-
/ Rcleamd— I7en.ntmcnt of
S WennilAFurmd,\pplication,c\Ruidenllnl\I1.1' Appllealiurt201U-07
(late
Fee
Secices
...........I
Last Updated 0111 W13