HomeMy WebLinkAbout06020002-Application
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City of Cannel/Gay Township Permit #: ()(PO~ODO~
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, lit Accessory Buildings
BUILDER of
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
NAME
[Oc-V ~-.JTC'L?.e
STllEET ADDRESS
/0/6 se.i)
BUILDER'S EMAlL ADDRESS
.::rc;e,ifsn~rlZ6,,"7L@El>{>-<) E.JT. CCIY/
I<lC
PHONE
-ecfB-
FAX
CITY
STATE
IAll>>IlJ.A
ZIP
'-I60~L
BEST METHOD OF CONTACT:
EmAIL <?~ Pt{cu[
NAME .2/(J10tJ fJROIf::Rr1 GROUP
STllEET ADDRESS <h-/)
//5 It/. WItSlilI1J070/J ..Jlf\ter
ADDR3 r COC!Al;IO~Jf{b f!,LVD
FAX
PHONE 3/7. 202. ~<f 7
!NlJ/!lN,1fOU!1 STATE/A!
ZIPt!02{)t.j
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J
Address of ShellJ5pil.ding (If different than Address of COnstruction
. Vf '[ (
BUILDING, PROJECT, OR TENANT NAME: ZONING:
TAX MAP PARCEL #:
STATE COMMERCIAL ~
DESIGN RELEASE #: -.::,{ '-/-b1JO
SCOPE(S) OF 0 FDN 0 STR 0 ARCH ~ MECH <<! PLUM
RELEASE: ....r ELEC 0 SPKLR OTHER(S):
SQUARE / -z -
FOOTAGE: ,"I::>
WATER UTILITY
PROVIDER:
SEWER UTILITY
PROVIDER:
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNlY WELL AND/OR SEPTIC PERMIT #'5 (If Applicable):
Elevator or Uft: 0 YES Ii( NO
BUDG. CONSTRUCTION TYPE:
PEO NDFOF1CON.~:
J8( COMM rr.ct to ;.om"JI'ln~e With ~;,ti~~'f{~:S,\~lJcruRE
(Privately owneafh&p~ an,j LOC31 C 0 AOOITRiN
anc@/!!IJ1'lll't>~es/'i""~ ",Ooes. 0 Room(s)
~er'dal)"r ~,)II1MUf\jjTY SERV~E rch
o INO ~i\LCARI\1F'-/CLAYTr\l^' ~ezzanmeorOeck
Mumopal/Pubhc Blag '13 ,. f'
o School INDIAN,t., g NEWTENANTFINISH
o Church 0 ACCESSORY BUILDING
FOUNDATION TYPE: (Check all which 0 DETACHED GARAGE
apply for the new construction area) 0 ATTACHED GARAGE
8l'" 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
lot # and SubdMslon (If Applicable)
ESTIMATED COST OF CONSTRUCTION: <7J /J Z Ei17.-
(EXCLUDING LAND VALUE) .p 1 ~ .
OCCUPANCY CLASSIFICATION: 6
PROJECT INFORMATION:
Early Release \ II Manufactured V
Permit: Y ,., N Trusses: -'\-?:N
Lot Split: - Y ~N Sump Pump: _Y-.4:.N
Does any part of the property lie within a special Flood
designation area: _Y ~
PLUMBING CONTRACTOR:
v: ~\'E..-
Plumber',s,Indlao;>.State License #:
I q'"1 rJUU'J,..1-f ~ - ~l'
Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 615 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 of J.e. 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
Occupancy or Substantial Completion has been issued by the Department of Community Services. Cannel, Indiana.
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Sign f Owner or Au orized Agent
r El<OS7RCJ2.~YL
Print
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Oate
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: Filing Fees: f:. 0 i ~)'
, I # Charged Re-
Upper F ting Lower Footing Under Slab Base Inspections: / C(;;l.. 5"L) Reviews
Meter Base 8 Site Cert of Occupancy: ' / 0 "1 ,() 0
, TO~~~ -I
OO(,~~-/~~G iOU,
,?Fi.:H\ecelved by:
Reviewed/App ved: Dept. of Community Services
S:PermIts,IForms/ILP MMEROAL
I' Additional Fees
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