HomeMy WebLinkAbout06020114-Application
I
City of Carmel! Clay Township Permit #: 0 (p 0 -:J.. 0 Utf
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings
BUILDER of
RECORD:
NAME (I L' ;1 , PHONE
Q rnQ{lM-G LOYJ'iltLu'.j1fu 31/-7/0.-S'101
FAX
317 - 7310 - VO 17
STREET ADDRESS
O'6r 3 f~ . 3S7J fJ
BUILDER'S EMAIL ADDRESS
((ca. mOIL/US)
i'Y\ O(UU .s. (l J).-V)
PROPERTY
OWNER:
NAME - rJ I'
~ 'Ke.41 +- l:1eCM-
3gA~~+L V}\u.'Ldliw $.f
€.cL :/JJ(J D '
LOCATION
&. PROJECT
INFO:
Address of Shell BuildIng (If different than Address of Construction)
'-S
WATER UTIUTY
PROVIDER:
SCOPE(S) OF 0 FDN 0 STI<
RELEASE: >'J ELEC 0 SPKLR
SEWER UTIUTY
PROVIDER:
PLAN COMMISSION ZA / BPW DOCKET NUMBERS; AND/OR
COUNn' WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Roars:
Elevator or Lift: Q YES j:ItJ NO
BLDG, CONSTI<UcnON TYPE:
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
'K'C. &<j)f'tlM.f'{l.Q.II!. 0 NEW STRUCTURE
~s ....~~iA!ly:;;Wn~d(iibsliOONSTRUCTD.I\DDmON
ubJ8Illt'1'~~,~~s!cen.ters " IUN 0 Room(s)
are Wfl1~!:qa~),:I,"i:!~~e With all roguJations 0 Porch
COENSTIl'tmONAL,:.,ld Lc'cel Corjp" - 0 Mezzanine or Deck
PffJOiiUnltiPA't~,~~tq.B!1~y 0[/ ~REMODEL
CIlY -. r,. - \ 'J..RVI NEW TENANT FINISH
~ ~~vlEl / CU, ( TOW I.rIlCCESSORY BUILDING
FOUNDATION TYPE: (l:;Ij~II'W'J}"(hich 0 DETACHED GARAGE
apply for the new construction area) 0 ATTACHED GARAGE
~ SLAB 0 CRAWL SPACE 0 CELL TOWER (New)
/0 POST & BEAM 0 BASEMENT 0 CELL TOWER CO'LOCATE
(or POST & PIER) WALKOUT:_Y_N 0 DEMOLmON
OTY .
rt:c./. ;....'UJ/U
STATE
..rxJ
ZIP
Lib! .3 /
BEST METHOD OF CONTAcr:
/10-5901 ~L.
PHONE
S/'l--$ DO
FAX
'S' -~o5"
OTY
.:pJ
STATE
JYW
ZIP
4fP ;W
t.~ Cl)r~
f>l
SU!fE # (If Applicable)
7/"v't
..
Lot # and Subdivision (If Applicable)
TAX MAP PARCEL #:
/A ?v4
t) () CJ
OCCUPANCY CLASSIFICATION:
PROJECT INFORMATION:
Early Release if
Permit: _Y.6,LN
Lot Split: _Y)t;.N Sump Pump: _Y KN
Does any part of the property lie within a special Flood
designation area: _Y Lf.~
PLUMBING CONTRACTOR~ efl-l _ _ .,UO
Plumber's Indiana State License #: p ~~
2!?'7/~(,
Manufactured \/
Trusses: _ Y .5...N
Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for
beginning and completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana - 1993" (Z~
289) and amendments, adopted under authority of LC. 36~ 7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Oc~if~cy or Substanti'" Coo:f{ction has been issued by the Depar~nt of Community Setvic~ Cannel, Indiana.
I::!f:Y::. ~ ~ ..JJ.11U1.e...IA. A J-J!!. u-r- L. -2.2 -0 ~
Signature of OWner or Authorized Agent Print Date
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: Filing Fees: '5' 06 .. 5'(;
J a '? r-o # Charged Re.
Upper Footing Lower Footing Under Slab Base Inspections: I f"- . -J Reviews
~ Meter Base e Site Cert. of Occupan / tJ "3.. 0 CJ
~ - tQl TOtAL-".~
, 11lT1\.J) (lK\r~~ ,-=P~. P'r. 200(, /~~-dt2Y~d~ '
Revlewed/~pproved: Dept. of Community Servlces (Dale) Fee ~ecelved by' .v
S:PermIt:s/FonnS/UP COMMERCIAL .
Additional Fees