HomeMy WebLinkAbout06010111-Application
City of Carmel/Clay Township Permit #: {)(eO/O If(
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
STATE
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/ BEST METliOO OF CONTACT: r f ~I
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BUILDER of
RECORD:
....
C:;",p
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BUILDER'S EMAI) ADDRESS
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PROPERTY
OWNER:
NAME-'1/.. '(:.
STREET ADDRESS
f't,f'. L.
'I' E: c".,...~
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LOCATION
8r. PROJECT
INFO:
ADDRESS OF CONSfRUCT10~ (
I L--tl,"""e... ,. t.."'C..
Address of Shell Building (If dIfferent than Address of Construction)
BUILDI G, PROJECT, OR TENANT NAM7
jC;,. ,i... bra
STATE COMMERCIAL
DESIGN RElEASE#: :5 /S62/
SCOPE(S) OF .p FDN 0 SfR P"AROi
RELEASE: rJ!J ELEC 0 SPKlR OTHER(S):
SEWER UTILITY / J
PROVIDER: L- () ( In fVf
WATER UTILITY
PROVIDER:
o ,,"" eA
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COU1'ITY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
PHONE
FAX
J>S9~ ~'27Y
ZIP
YI2.j'f
,'.1
Jpi-6 27 S-
CITY
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1.5.
PHONE
l''Ir-Yf9 J
CITY
Co.......!
FAX
7YY-YblJ
p'O?.2..
STATE
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SUITE # (If Applicable)
6l.tJO
Lot # and Subdivision (If Applicable)
TAX MAP PARCEL #:
~LUM
..rMECH
SQUARE r-
FOOTAGE: / U
10 .(JOr:, e:-
ESTlMATED COST OF CONSfRUCT10N:
(EXCLUDING LAND VALUE)
# of Floors:
Elevator or Lift:
YES [) NO
BLDG. CONSfRUCT10N TYPE: f{.../
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
~MMERClAl 0 NEW STRUCTURE
(Privately own~!!p;>pitals 0 AOOmON
and medical ofltbl!;.<fa1A6ED FOR CaNSO ~~m(sl
arecommercl~ub' t!JllPo,dlIUN
o INsrmmONAt jec! to Compliance with a[)G(~' r Deck
o Mumapal/Public Bill1ltate an'1 I. OSW" Mg. D~l .\\'9~g
o SchoolDEPT OF COMMUl' ","Nt:WcTI;~I\NT FINISH
o ChuP.lTV () ~ _ T AECESSofiilliifbDING
FOUNDATION TYP~ntHetl('aIl~v1 ELI Ctt:}'l, \Pi:1l"&\:I{lP<~~
apply for the new construction area) INDIA~CiI ATTACHED G1>.'RJ(GE
o SLAB 0 CRAWL SPACE tJ CEll TOWER (New)
~ST & BEAM 0 BASEMENT 0 CELL TOWER CO.-LOCATE
(or POST & PIER) WALKo.UT: Y N 0 DEMOliTIo.N
PROJECT INFORMATION:
Early Release ~ Manufactured V
Permit: Y N Trusses: Y ~
lot Split: Y Sump Pump: _Y ~N
Does any part of the property lie within a specia~;;;od
designation area: _Y ~
PLUMBING CONTRACTOR: /
r s at /'1 pJ.o.f>.
Plumber's Indiana State License #:
pC f 1057 Y-Qo----..-..----.---,
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Class I structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 17)regardiIig expiration-time fr~~ \
beginning and completing construction, .1 J \ \ It II
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or anYlchange in the }lse of l~nd or st~ret> J
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning prdin~Nof Qar@.elltl'd'!@a - 1~~" (~t
289) and amendments, adopted under authority of I.e. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory'ihereto. I further certi!Y~t only
kitchen, bath, and floor drains are connected to the sanitary sewer, I further certify that the construction will not b~ u'~e~ or occupied until a Certilica.~eQf.J 1
Occupancy or Subs 'a] Ci /clio has n issued by the Department of ~unitY. Servi~ C~el,. In~a L__~.___ I
/,/.,,.k ulm.~ /-19-~
_ r
5 nature of Print Date
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: Filing Fees: (;;1. 1. AS
CI r # Charged Re-
lower Footing Under Slab Base Inspections: II ;l, ..J 0 Reviews
Meter Base ~ Site Cert, of Occupancy: J CJ 3. 0 0
~ :fP. q ~ J/ 70 Additional Fees
~~ l~'1JIJI-
T~
~e Received by: L a