HomeMy WebLinkAbout05120088-Application
City of Carmel/Clay Township Permit #: tJ~r2()t!!/6
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
BUILDER of
RECORD:
NAME
PROPERTY
OWNER:
;-.}",j L'ard-r.J;t!>'"
Dr.
,'.f.ol
.;
0<'". .
D1.
LOCATION
& PROJECT
INFO:
ADDRESS OF CONSlRUCTlON
BUILDING, PROJECT~ OR TENANT AME:
tJ~bY' 'f1J.~
STATE COMMERCIAL
DESIGNRELEASE#: 3P!i2f7
WATER UTIUTY -r
PROVIDER: J- IN'L
. :.:L .c:
SCOPE(S) OF f!i{ FDN 0 SlR
RElEASE: 0 ELEC 0 SPKLR
SEWER UTIUTY
PROVIDER: t'-I/l.. w
PLAN COMMISSION / BZA / BPW DOO<ET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Floors: 1
Elevator or Uft: c;J YES jJ{ NO
-fyPE9F CO!'lSTRUcnON:
~ . COMMERCIAL
(Privately owned hospitals
and medical officeS/centers
are commercial)
o INSTTIUTlONAL
o Municipal/Public Bldg
o School
o Church
FOUNDATION TYPE: (Check all which
apply for the new construction area)
.1M SLAB 0 CRAWL SPACE
o POST &. BEAM 0 BASEMENT
(or POST &. PIER) WALKOUT:_Y_N
o
o
o
o
o
o
o
o
PHONE
FAX
'-/8.?
0/'8 J.-
CITY
ZIP
~d.sB
sum # (If Applicable)
Lot # and Subdivision (If Applicable)
ZONING:
TAX MAP PARCEL #:
f"30 IUJO 000 S3 00
o MECH 0
Early Release ~ Manufactured _Y <\- N
Permit: Y N Trusses: IV
Lot Split: - Y ~N Sump Pump: _Y 'It N
Does any part of the property lie within a special Flood
designation area: _Y X-N "IliA^-
PLUMBING CONTRACTOR: B ~ lZ l)'^"\l . -
Plumber's Indiana State License #:
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.
It 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 ofle. 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 connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Dc cyor bstantial C tion has been issued by the Department of Commuruty Services, Cannel, Indiana.
. AAOTHV C;. OltOJ ~o.te .
Print I
Reviewed!
S:Permits/Fonn