HomeMy WebLinkAbout05120089-Application
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City of Cannell aay Township Permit #: fJ ~ (2tJ><l1
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory BUiidings
BUILDER of
RECORD:
NAME
La-
STREET ADDRESS
q5?3D
L/82?
71-51/2')...
BUILDER'S EMAIL ADDRESS
PROPERTY
OWNER:
NAME
iJ;J/;<i:v~ fl-
LOCATION
& PROJECT
INFO:
ADDRESS OF CONSTRUCTION
PHONE
FAX
CITY STATE ZIP
-r"cI ;~O~ /.'.5 :IN '-16:)80
BEST METHOD OF CONTA~ . I
. c:.o> yv'\ .;l a t; 7J92. - yvJ<t..1
r.
;-/.o/
-I
PHONE
57'-/- Sl/ 20
FAX
8d9 - JDS'J-.
CITY
STATE
:EN
Address of Shell Building (If djfferent than Address of Construction)
147
WATER UTIUlY -r" SEWER UTIUlY ESTIMATED COST 0 ~ !,W!;
PROVIDER: .J-!tv' C- PROVIDER: LT A t.J I:) (EXCLUDING~U.~(),\.I\a.\\O
PLAN COMMISSION/BZA/BPW DOCKET NUMBERS; AND/OR ~O f\. c,e'~\\\\ ~oes, C~S
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable): \..€.",-S rO(\,\\,\\'L\~r\ I..or)}\ (" c.'i'_\'\\!\ \'?
# of Roors: I Elevator or Uft: Q YES jiJ NO BLDG. CONSTRUCTI!UtiPl!? 0\ ~i\,~e '.' ~I'!i"~ ~Nl\Y.a~ IFICATION:
,.- _, I
TYPE OF IMPROVEMENT: ~'? . RMA. N:
jl(i NEW STRUcruRE Q """ ~I eleas;..\O\~' Manufactured VI
o ADDmON C~\' Permit: _Y N Trusses: _Y ~N
8 ~=(S) Lot Split: _Y N Sump Pump: _y--.k.N
o Mezzanine or Deck Does any part of the property lie within a special Flood
o REMODEL d' . V
o NEW TENANT FINISH eSlgnation area: - Y ~N 1\" aA^
o ACCESSORY BUILDING PLUMBING CONTRACTOR: ~ t::-O......(] . -
o DETACHED GARAGE
o ATTACHED GARAGE
o CELL TOWER (New)
o CELL TOWER CO-LOCATE
o DEMOLmON
B~ILDING, PROJE~ OR TENANT NAME:
tJ~l>" r-o;",-re... Il. {lJ"
STATE COMMERCIAL
DESIGN RElEASE #: 3/
TYPE OF CONSTRUCTION:
l;iQ COMMERCIAL
(Privately owned hospitals
and medical offices/centers
are commercial)
o INSTITUTIONAL
o Municipal/Public Bldg
o School
o Church
FOUNDATION TYPE: (Check all which
apply for the new construction area)
M SLAB 0 CRAWL SPACE
o POST & BEAM 0 BASEMENT
(or POST & PIER) WALKOUT:_Y_N
Lot # and Subdivision (If Applicable)
ZONING:
TAX MAP PARCEL #:
SCOPE(S) OF 00 FDN 0 STR 0 ARCH
RELEASE: 0 'ruc 0 SPKLR OTHER(S):
o PLUM
SQUARE
FOOTAGE:
o MECH
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.
t, ~e 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 I.e. 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
Decu '}'orSubsc 'a/CompJe ~asbeenissUedbYtheDeP~~;;utyi;~J5;::tIndiana. J7.{lr!OS
ent Print , Date