HomeMy WebLinkAbout06010141-Application
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ityofCarmel/Clay Township Permit#:~
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
BUILDER of NAME PHONE FAX
RECORD: N<(fio. -r. h 3-
CITY STATE ZIP
~' f', ' "TN '-(
BUILDER'S EMAlL ADDRESS BEST METHOD OF CONTACT:
~Di r>') -tV
PROPERTY NAME PHONE
OWNER: ~;C> "- 0/( r:' F .3.,
STREET ADDRESS CITY STATE ZIP
'3'72..0 ::s..J 4
LOCATION ADDRESS OF CONSTRUCTION
&. PROJECT 13/ L 3:~ ! ; ~
INFO: Address of Shell Building (If different than Address of Construction)
BUILDING, PROJECT, OR TENANT NAME:
'~'^'"' n
STATE COMMERCIAL
DESIGN RELEASE #:
""&j, 1~
lONING:
PD
31
SCOPE(S) OF /0 FDN 0 STR ARCH
RELEASE: "" ELEC 0 SPKLR OTHER(S):
o MECH
SQUARE
FOOTAGE: 5 '
WATER UTILITY
PROVIDER: \J ' L, - ~ "
~ IP.""'-""\"j ..:.....Jt::>
PLAN COMMISSION I BZA I BPW DOCKET NUMBERS; ANDIOR
COUNTY WELL ANDIOR SEPTIC PERMIT #'S (If Applicable):
SEWER UTILITY
. }'ROVlDER:
V\,,);~'
ESllMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) ~ I
# of Floors,; Elevator or LIft: 11) YES i:? NO BLDG. CONSTRUCTION TYPE: \1- OCCUPANCY CLASSIFICATION: is 1.-
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PROJECT INFORMATION:
t::!l: COMMEROAiRELEASED FOR COtiSNEWSi:RUcru~E Early Release Manufactured,_
(Privatelyo~1! COfnDitR;lce V,GDl ,AoomONtions Permit: _Y A-N Trusses: _Y~N
and medicai'offices7cenlers,., . .1 I " ':It ("' (O'~ Room(s) \J
.recommercial) or ~late 2r,(. ,CC'." _JO r;:J" P c(1 Lot Split: _Y _N Sump Pump: _Y ~N
o INSTITUTIOI9EPT OF COMMUNITY ~;'gR\lehiiiirie or Deck Does any part of the property lie within a special Flood
o Mu~Wtj~ ~RMEL f Co,,:,{R1it@I?~~<SH!P designation area: _Y V N
o S~ "I ,~NEWTENANTFlNISH .L:L
o Church II~li,Ai'~ ACCESSORY BUILDING PLUMBING CONTRACTOR: ~~~\ 7f~ ,'_" ,;;:;-__;."::::"""'_'_"
:~~~:~~Nn~~n~C::~~o~I:':~~h 8 ~.g::~~~g ~~~~ ~; K 1,r,~\U ~)v-v.b;J I! U I :=::.!J;7 !i;;~ n \\; j;~ iF,\ .
t3 SLAB 0 'CRAWL SPACE 0 CELL TOWER (New) Plumber's I~diana State Li~!/I--"':'--I/LI ) Ii i
9or~~~Bp~~ ~A~g::ENT Y_N 8 g~~~T~~~CO-LOCATE l"ln"'<'Z. III U JAN 242006 Jill
..1 .I I 'I
Class I structure permits are subject to the General Administrative Rules of the Sta.te of Indiana (See 675 IAC 12) regJding e~.time,frames for J __j
beginning and completing construction. I
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any changein.tbe.use.9.f1!2.d_ or structures
requested by this application will comply with, and confonn to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indl~1993n(z-_.__ -__J
289) and amendments, adopted under authority of LC. 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
cupancy or Substantial Completion has been issued by the Department of Community Services, Cannel, Indiana.
~ ~~~~i~'~~
Signa re of OWner or Authorized Agent Print
I-Z'I-c.lI
Oate
I
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: Filing Fees: /3 '1/. Cf /
. . / q '1' # Charged Re-
Upper Footing Lower FootIng Under Slab Base Inspections: I IX . S 0 Reviews
'-;OU9h~~ ) Meter Base ,~ Site Cert. qfoc~cupanCY: /!J 3.0 7J
~ ~ ('_~' AdditiorialFees
. \, ,,0Ji\. TOTA~%~71
Reviewed! prove Dept. of Community SelVicei!; (Date) Fee Received by:
S:Permits/FormS!ILP COMMERQAl \