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City of Carmel/Clay Township Permit #: (J(aO?-ooOq
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
TUft
J'I PHONE
\....().<J~r, L./..,C .:!17-'8/7-0%()
FAX
317- 817'o3~ Z.
BUILDER of
RECORD:
NAMES I
STREET ADDRESS
7~ 3&9-
tJ~ S,M.
PROPERTY
OWNER:
BUILDER'S EMAIL ADDRESS
s+e.Jew
NA~
,'//F /T)cAlTlll/.-
5./iJ.
LOCATION
& PROJECT
INFO:
{!.
CITY
/tilt u...
J../.. e.
Address of Shell Building (If different than Address of Construction)
BUILDING, PROJECT, OR TENANT NAME:
't.O 7"i.w~ :5H()P'S Or (!.
STATE COMMEROAL
DESIGN RELEASE #: 3/S-847
WATER lITlLITY
PROVIDER:
(.. PH
SCOPE(S) OF % FDN 0 STR
RELEASE: 0 ELEC 0 SPKLR
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
CCUmY WELL ANDIOR SEPTIC PERMIT #'S (If Applicable):
# of Roors: 3 Elevator or Uft: Jl YES Q NO BLDG. CONSTRUCTlON TYPE:
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
crl COMMEROAt.RELEASE'D FOR CrM,,~,~UCTURE
(Privately o-S~'ilI.s. , ' ~:z!Y"":rlrlbll6rr'ON
and medical offlce\;7~htl!J\pomp"2nce with illllieg~
are commercial) of State anti ( 01"'1 C r,. Porch S
o INSTITUllO'""EP -, -'. OC""3
o M~~vpkf>lfd~OMMUI'JI(5Y Riii?ffitiCes or Deck
o Scrtdb' T UI- CARMEL / Clc;<l,yr-m~SH
o Churcl1 itr\IDI J;;J ACCES~6f1.'T'IlUJ[D1NG
FOUNDATION TYPE: (Check all whicH' AN'tJ DETACHED GARAGE
apply for the new construction area) ,0 ATTACHED GARAGE
~ SLAB 0 CRAWL SPACE / 0 CELL TOWER (New)
o POST & BEAM 0 BASEMENT / 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOLrr:_yLN 0 DEMOUllON
SEWER lITlLITY
PROVIDER:
STATE
IIfJ
ZIP
t'l tJ 32--
BEST METHOD OF CONTACT:
~(!>I<e
PHONE
.3'17 .
FAX
em
t:) ,g
STATE
/AJ
2-
t..
TAXMAPPARCEl#: -r ~
030030(00 000
o ARCH 0 MECH 0 PLUM SQUARE I
OTHER(S): FOOTAGE: / CR c; fL tJ '10774
E5T1MATED COST OF CONSTRUcnON: PtJ(t"'MTI~I<<>O-
(EXCLUDING LAND VALUE) __ +.. ....,
flTJ'. '- ~ -,~O (Je;Jo
t/- 8
OCCUPANCY CLASSIFICATION: It.( 13 e-2.
PROJECT INFORMATION:
Early Release.).. /' Manufactured V
Permit: ~y ~N Trusses: _Y _N
LotSpllt: _YLN Sump Pump: _Y LN
Does any part'of the property lie within a special Flood
designation area: _Y V N
PLUMBING CONTRACTOR: I
z..~a-z..IJ(e!"C-HAAJICAtJ -:}.'5, lIfeG.
Plumber's Indiana State License #:
Class I structure pennits 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 Cannel Indiana - 1993" (Z-
289) and amendments, adopted under authority of I.C. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, or ins are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certilica.te of
Occupancy 'aJ Completion has heen issued hy the Departme~ ~:U:ty se'fj ~e1:7~.t".
,:~;rl ~ '- U/,.,.-&!!!...~ ~b~(,
of Owner or Authorized Agent Print Date
OFFICEUSEONLY:************************************************************************
. Filing Fees: )y If ~-'V
Base Inspections: P./.rt /Yk.h
Cert. of Occupancy: 1ft /// 1:3 /leL-v- v(
L ~ / 0 Additional Fees
~T~A'/',n/)/~<
FeZjfbY:' - z.~
~
Revlewed/ pproved: Dept. of CommuniIy Services
S:Permlts/ S/ILP COMMERCIAL
(Date)
"
# Charged Re-
Reviews