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HomeMy WebLinkAbout06020001-Application City of Carmel/Clay Township Permit #: QCa 0 d.a)()\ COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings BUILDER of NAME RECORD: STREET ADDRESS PROPERTY OWNER: LOCATION &. PROJECT INFO: / Address o~ Shell Building (If dlffere than Address of Constructl.on) BUILDI I PROJEcr, OR TENANT NAME: STATE COMMERCIAL DESIGN RELEASE #: . SCOPE(S) OF . 0 FDN 0 STR RELEASE: ,p< ELfC 0 SPKlR SEWER LmLITY , , ) PROVIDER: t-rA IV WATER LmLITY. PROVIDER: PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable): ~~ # of Roors: Elevator or Uft: c;I YES NO BLDG. CONSTRUcnON TYPE: FAX Lot # and SubdMslon (If Applicable) I ESTIMATED COST OF CONSTRUCTION: (EXCLUDING LAND VALUE) tf~ fj3'l OCCUPANCY CLASSIFICATION: TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: ;P-' COMMEROAL 1M NEW STRUCTURE . (Privately owned hospitals '13 - ADOmON and medical offices/centers 0 Room(s) ~Ei~:bR CONSTRUCTION 0 porch. Subj({!;t t<MlinidPiil/PUbli@lildg') all mqulatcrs E~OD~~a",ne or Deck o oSCHoole 3~ld Local Codes. ~EW TENANT ANISH =-lfl ,,\ly'nr1.ML',,ITi St:RV1(tIlSACCESSORYBUILDING b(C~"Fk,a'l,yv~,lc,h__-\'Vr.' q-, I~ACHED GARAGE ap conslructlon.area) I U. 'e:J" ATTACHED GARAGE .Ji'! SLAB d;~ r;?AAWt'SPACE 0 CELL TOWER (New) - Li POST & BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE (or POST & PIER) WALKOUT:_Y_N 0 DEMOUTION PROJECT INFORMATION: Early, Release V Manufactured Permit: _Y~N Trusses: _Y XN Lot Split: _Y XN Sump Pump: _Y 1N Does any part of the property lie within a special Flood designation area: _Y ~N PLUMBING CONTRACTOR: !?/J ~)~ /';::.-.'\ r /.~c. \~I" PI~ :;"1ndia~.a/~~ L1ce~!t;:;\;"rj ':Si",\ \\\ u--r d'/f~1' 7/ 2-~~ -,c:,,;, I;, ...-C/' \'\ \ \\ ...........-:~, l, /) ./..- \\\ \i\ Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 rA~12) ~~t.uuiiii expiratij . ~\ia'r;J \ beginning and completing construction. \\ \ \ \ \ ') I,.: :> \ I. the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or ~y .ch~e in ~ ~ dr land or strucrores ~ requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning~Oidinance~annel Indjana-==-I993" (2'.,..-/ 289) and amendments, adopted under authority of l.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts ~'endafury thereto. Uutther certify...that-only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be ushi\or 'cic't.upieduiitiI a Certi/jate of Occupancy or Su Camp). tion h ued by the Department of Community Services, Cannel, Indiana. \'0 v \/ /" \ ~ a-;2~,t7~ \".-'" Date .a;~~ ~ ~/;;d~AJI' Print OFFICEUSEONLY:************************************************************************ 3 -::,3 1 . '10 / c;- .?_ 51) / b ~ ./1 () , .hi: .3 3 _) Additional Fees u. - 'V (7 ~~ INSPECTIONS REQUIRED: Filing Fees: Base Inspections: # Charged Re- Reviews Lower Footing Under Slab Meter Base @ Site Reviewedl proved: Dept. of Community Services S:PermIt5/FomiS/liP COMMEROAL ~