HomeMy WebLinkAbout06030011 Application
City of Cannell Clay Township Permit #: 0 {p 03('){) l{
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
BUILDER of
RECORD:
NAME ~
L> Let C
STREET ADDRESS
[
CO PHONE j 1'7 FAX <3/7-
" 7'>tJ 1508 -I" 000 1:0 g-.,;. +
1\ CITY ZIP
s+ s: e. lOC)
PROPERTY
OWNER:
cL,,-
~ec-~+ LP
Lc ~ $'1-
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BEST METliOD OF CONTACT:
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FAX <3/=t.
F:og-(., +97-
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CITY
STATE
J
ZIP
~,
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LOCATION
8< PROJECT
INFO:
ADDRESS OF CONSTRUCTION
()o C.
s,
~,,-,,--t
00
SUITE # (If Applicable)
00
Lot # and Subdivision (If A~plij9ble) 55 r (l
" )0001.. GrD
ZONING: TAX MAP PARCEL #:
.B Co /1-, /3 ./.) .GO-. (J ,.() I J. 00
o STR ~ARCH ~ECH qvPLUM SQUARE
o SPKLR OTHER(S): FOOTAGE: '-I;) S '7
G ir<- wy. ESITMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) g> ~ () 000
, . - .
Class I structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC l~) regarding expiration time frames for"
beginning and completing construction. / i ;
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any changf~R We use q,f 1afi.13:~~structu.res ' .
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "'Zoning qrdinaiit"eldf CiitIIJ.el I:h:diana - 199r (:;~
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 c~~ that o~ly
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 Ceitihca.te of
Occupancy or Substantial ompJetion has been issued by the Department of Community Services, Carmel, Indiana.
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Signature of ner or Authorized Agent Print
Address of Shell Building (If different than Address of Construction)
BUILDING, PROJECT, OR TENANT NAME:
~ 0
STATE COMMERCIAL
DESIGN RELEASE #:
SCOPE(S) OF 0 FDN
RELEASE: ~EC
SEWER UTIlITY
PROVIDER:
2> I ~ JG 5'
WATER UTIlITY
PROVIDER: -r V'.l l s .
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of FlOOrs:
Elevator or Uft: 0 YES 0 NO
BLDG. CONSTRUCTION lYPE:
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
M COMMERCIAL 0 NEW STRUCTURE
"\. (Privately owned h<!p~~s 0 .APP.illON
and medical offlcesf<ltllt.rEASED FOR CUf!tJ; lilbcin\&;TION
ore commercial) S b' t t " . ~ '(9~11'<11:d1 lations
o INSTI1U1l0NAL U Jee 0 eOrnpola,\~Q WI. a . .~u
of S~"+;;'.:> '.Ir~(' I, ,~~o..(lMezzanmeorDeck
o Munidpal/Public Bldg lu,,, 0." tJJ REMODE~uo,
o School DEPT OF CCrn~~'NB\(rENANT.fOO!;j$
o Church ("ITV nl= rAR".AClO OACCESSORYlBllnll"'''''p
FOUNDATION TYPE: (Clll\tUIJ'M1iCli I." L. -0 DETACHED GAiiA~l'li
apply for the new construction area) I N [~~..:frACHED GARAGE
czi 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 OEMOUTION
o
OCCUPANCY CLASSIFICATION:
PROJECT INFORMATION:
Manufactured
Trusses: _y.K.N
Early Release ><
Permit: _Y ~N
Lot Split: _Y..A.N Sump Pump: _Y AN
Does any part of the property lie within a special Fli.od
designation area: y A-N .. ~ ,
PLUMBING CONTRACToR,,*~ f1, ~~. '-"
ii2>l;, \j
Plumber's Indiana State License #:
.3-/=-'00
Da'"
OFFICE USE ONLY: ***************************************** *******************************
INSPECTIONS REQUIRED: Filing Fees: .,.832'a. &1
CI ') r # Charged Re-
Uppe~oting Lower Footing Under Slab Base Inspections: I 1'>' .::10 Reviews
r;:;,~) Meter Base ~ Site Cert. of Occupancy: / () :3 I {;O
~~ ~ ~
~ Reviewed pr~~ed: Depl. of Community SelVices
l \ S:PermIts/FonnS/ILP COMMEROAL
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