HomeMy WebLinkAbout06010113-Application
City of Carmell Clay Township Permit #: f)CJ; fJ I V /(3
CO:MMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, lit Accessory Buildings
BUILDER of
RECORD:
NAME
~OrJ INe..
STREET ADDRESS
j,J
BUILDER'S EMAIL ADDRESS
PROPERTY
OWNER:
NAME
LOCATION
8r. PROJECT
INFO:
BUILDING, PROJECT, OR TENANT NAME;
-f A'
WATER UTIllTY
PROVIDER:
SEWER UTIllTY
PROVIDER:
PlAN COMMISSION / BZA / BPW 0 NUMBERS; AND/OR
COUN1Y WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Floors: j Elevator or Uft: .
BLDG. CONSTRUCTION lYPE:
TY~'CONSTRUCTION: TYPE OF IMPROVEMENT:
, ~~~f,;P~9&s co~sTRuc8lcm'~~CTURE
~'l&'<ii&iI~fflcesrc~nl1!lSO whh all regulationSJ Room(s)
o are com{!)~rg!!J.te an(j local Cocles. 0 Porch
f!lI~'DU.,,~ ""ITY "~I"'\U;(" 0 Mezzanine or Deck
~ 'Mb1\IdPaift'ubhC'~ldg' ;:'c. 'ftODEL
ClntJOICtQlARMEL / CLAY TO JlImbTENANT FINISH
. 0 Church 1/\1 Itl ' l - AeCESSORY BUILDING
FOUNDATION TYPE: (ChE!tR'8I ~h'i&. 0 DETACHED GARAGE
apply for the new construction area) 0 ATTACHED GARAGE
o SLAB 0 CRAWL SPACE 0 CELL TOWER (New)
o POST & BEAM '&0', BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) /WALKOUT: Y N 0 DEMOLITION
PHONE
o
o
CITY
STATE
'L'
ZIP
CO /"VI
FAX
ZIP
t,OS~
Lot # an u v slon
picable)
TAX MAP PARCEL #:
e3-f'f€CH
SQUARE
FOOTAGE: / "} C> 0
ESllMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)~ 0 0 C) 0 CZ> 0
OCCUPANCY CLASSIFICATION:
PROJECT INFORMATION:
Early Release / Manufactured /
Permit: _Y ~N Trusses: ~ _y~
Lot Split: _Y ~ Sump Pump: _Y_N
Does any part of the prope~lthln a special Flood
designation area: _Y_N
PLUMBING CONTRACTOR:
K /1' I< 6 -f-f-
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 ofI.C. 3f)..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
OccupanCJ'. or ubstantial C pJetia en issued by the Department of Conununity Services, C~diana.
lie"'/' /YJ e N ,:50>' T-c
Print
l{rJl"J/a b
Da
OFFICE USE ONLY: **************************************** ********************************
INSPECTIONS REQUIRED: Filing Fees: 59 &, .., 00
La""" "'D # Charged Re-
Upper Footing Lower Footing Under Slab Base Inspections: I p\. U' Reviews
c9 Meter Base e Site Cert. of Occupancy: J D '3. 0 0
/.SD
IltfI
Revlewed/A proved: Dept. of Community Services (Date)
S:PermIts/FormsjUP COMMEROAl