HomeMy WebLinkAbout06010112-Application
City of Carmel/Clay Township Permit #:~Z-
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings
BUILDER of NAME FAX
RECORD: ~3 0
ZIP
BUILDER'S EMAIL ADDRESS
(IVG
PROPERTY NAME PHONE FAX
OWNER: ,~c. s
SlREET ADDRESS OTY STATE ZIP
ADDRESS OF CONSTRUCT10N SUITE # (If Applicable)
L I ;';0/ 51 c.4rm S'<f.s-
Address of Shell Building (If different than Addrfta~~ t=oF=i ~~t~c:if~APPIrCable)
S hI. t 'r:.:' j..;, l~ ~ . .'. .~" __
,. '.'. . - ....,,,.::l U
",.", '01 Ct~~~\j;! Local Codes, 'TAX MAP PARCEL#:
Cellf ,., DEPTH ,M 1\1 cc
SCOPE(S)OF G~F~!:~IJI:>~I =." '~Hr H" SQUARE
RELEASE: =acC rys~'rJi. "'dtH~%~i ,':,tAY, . FOOTAGE: .2 )6 CJ
SEWER UTIlITY J ESTIMATED cosT OF CONSTRUCT10NL 60
PROVlDER: e.:-r f.-W (EXCLUDlNGLANDVAlUE) 7~ 0 () C> c)
LOCATION
8< PROJECT
INFO:
STATE COMMERCIAL
DESIGN RELEASE #:
WATER UTIlITY
PROVlOER:
PLAN COMMISSION I BZA / BPW DO ET NUMBERS; AND/OR
CQUNlY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Roors: ~
TYPE OF C NSTRUCT ON:
COMMEROAL
(Privately owned hospitals
and medical offices/centers
are commercial)
o INSTmmONAL
o Municipal/Public Bldg
o School
o Church
FOUNDATION TYPE: (Check all which
a~ f~r. ~e new con~~~~~.~~~~_"
o NO
BLDG, CONSTRUCT10N lYPE:
OCCUPANCY CLASSIFICATION:
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ADDmON
o Room(s)
o Porch
o Mezzanine or Deck
o ftMODEL
cB' NEW .
o Aa;
o
Sump Pump: _Y VN
. the property I!,!l within a special Flood
designation area: _Y~.
PLUMBING CONTRACTOR:
Dt:J::-fV]
\ 'o;~;;"'-"
'- ANT ANISH
SORY BUILDING
DETACHED GARAGE
ATTACHED GARAGE
CELL TOWER (New)
CELL TOWER CO-LOCATE
DEMOLITION
L 0'2. 1)"3' ~ ":J 0
Plumber's Indiana State License #:
.HUts 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.
""gree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
,.f'plication will comply with. and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Cannel Indiana -1993" (Z;
:lents, adopted under authority of I.c. 36'7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
. and floor drains are c nected to the sanitary sewer. I funher certify that the construction will not be used or occupied until a Certificate of
.y or Su tantial Co .on h n i ued by the Department of Conununity Services, CannelAdiana.
;k Y' o-r ~ IAJ t5... 0 JI' r <.... / - :;)0 /0 V
Print Date
OFFICEUSEONLY:************************************************************************
78(".00
Ii'7.60
Cert. of Occupancy: /03.. 00
T~L: ~:8/,SC>
~ {dy t2 t{ / 'df ii;:;"
Received b ---
INSPEcnONS REQUIRED:
Filing Fees:
Base Inspections:
Upper Footing Lower Footing
~ Meter Base
Under Slab
# Charged Re-
Reviews
Additional Fees
I O/J /t'J~