HomeMy WebLinkAbout06010146-Application
Permit #:
OWI~lq&
City of Carmell Clay Township
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
BUILDER of
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
~r1)t
roe . e.L>
R~ €
BUILDING, PROJECT, OR TENANT NAME:
U"
STATE COMMERCIAL
DESIGN RELEASE #:
SCOPE(S) OF 0 FDN 0
RELEASE: ~ ELEC
SEWER UTIUTY
PROVIDER: C4...~
WATER UTIUTY
PROVIDER: G r~
PlAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WEll AND/OR SEPTlC PERMIT #'S (If Applicable):
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
~ ra~D FOR CONSTRUC([10~ STRUCTURE
SU~d \OlI'ed ;P'I'L)~,'!~'J'ie~~~8 with all regulalio/lQDmON
a m ~~Q;~~c ~.c~nters.....~, .... D Room(s)
are coriitl.eltial)e ",10 _vval Codes. 0 Porch
OC~~~r~1,i~~~ ;~~~E~~~A::i:::S:Ck
o Church INDIANA b' ACCESSORY BUILDING
FOUNDATION TYPE: (Check all which 0 DETACHED GARAGE
apply for the new construction area) 0 ATTACHED GARAGE
OI! SLAB 0 CRAWL SPACE 0 CELL TOWER (New) Plumber's Indiana State License #: /:'/<. '.' . ;,
tJ POST&BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE P ./?/.,~< ..>.\.\~
(or POST & PIER) WALKOUT:_Y..]LN 0 DEMOUTlON Cf?880U.02.. ~~J;~/">A, \;0 \\
Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12}~.-/, ,_ _..t~trifi6n"time fnun~Ji. .
beginning and cOIIlpletingconstruction. \\..0 ~ ... 1 1.\)'0 \.. .:... '
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any ~h. i use of l~~ 6~ructures \\....
requested by this application will comply with, and confoau to, all applicable laws of the State of Indiana, and the "Zoning' \ . '\I.hTi~~a - 1993" ( ..
289) and amendments, adopted under authority of Le. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amenftt:-'; \ t tri.' l'ttirther ce:9fy'tIlat only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used 'or \oc ~ ie til a Certificate of .
Occupancy bstantial [etion has been issued by the Department of Community Services, Cannel, Indiana. \\ \. V'-
-:J';;/,,, S. /<:,..jv.11C V '\ /;,z:i::'o'
Print ' , ~D.te
# of Floors: I
Elevator or Lift: 0 YES J( NO
BlDG. CONSTRUCT10N TYPE:
OFFICEUSEONLY:************************************************************************
fe3t.f.OO
/9~..so
/0 Y. 0 0
50
PHONE
8V3-22 '2.
FAX
~7-I'SY.3
OTY
{Arm
ZIP
'160:12.
BEST METliOD OF CONTACT:
Cell 5'07-
'30
PHONE
~ $-221'2-
FAX
s-
CITY
~'OJII~
STATE lIP
-::r;:N L( (.0 '3"2-
SUffi# (lfAppllcable) ,ev\1. ~ ..,1-
- II'td' ~~ &I'
Lot # and Subdivision (If Appllcable)
TAX MAP PARCEL #:
'0 UPOOPOS2.000
SQUARE
FOOTAGE: _ 1'100.
ESTIMATED COST OF CONSTRUCT10N:~
(EXCLUDING LAND VAlUE) ~O(JD
OCCUPANCY CLASSIFICATION:
PROJECT INFORMATION:
Early Release Manufactured
Permit: _Y..K..N Trusses: _Y ~N.
Lot Split: _Y iN Sump Pump: _Y X.:N
,
Does any part of the property lie within a special Flood
designation area: _Y lL.N
PLUMBING CONTRACTOR:
CB /I1ec~"I'erJ
Lower Footing Under Slab
Meter Base ~ Site
Filing Fees:
Base Inspections:
Cert. of Occupancy:
# Charged Re-
Reviews
INSPECTIONS REQUIRED:
Upper Footing
~
jApproved: Dept. of Community Services
sllLP COMMERCIAL
Additional Fees